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Guillain-Barré Syndrome - Development of Muscle Weakness

By Deborah Fields, BSc (Hons), PgDip, MCIPR

Guillain-Barré syndrome is an autoimmune disorder which results in the fast development of muscle weakness in a patient. It affects both women and men and can also impact anyone of any age although it can be more severe in the elderly.

The syndrome tends to develop in the patient after they have experienced a viral or bacterial infection from another disease. Patients have, for example, suffered from influenza, gastroenteritis or a respiratory tract infection in advance of Guillain-Barré syndrome symptoms starting. The syndrome has also been linked to the Zika virus, a disease spread by mosquitoes.

Following the infection, the patient is then likely to experience tingling in their fingers or toes, numbness or pain. They might have all symptoms or the different kinds in various combinations. This initial stage is then followed by a rapid progression of muscle weakness. On average, this can happen over two weeks but can sometimes take around four weeks. The symptoms then plateau.

The severity of the disease can vary but it can result in some patients becoming quadriplegic. When it is in its most acute phase it can be dangerous and occasionally patients die, although this is rare. Complications can arise because of blood clots or cardiac arrest. Most patients do make a full recovery, although for some patients it may take months.

What happens in the body during Guillain-Barré syndrome?

In the syndrome, the body’s immune system starts attacking itself. The antibodies in the blood, which usually fight diseases, begin to damage the peripheral nervous system, a collection of nerves and ganglia outside the brain and spinal cord.

The brain uses the peripheral nervous system’s motor nerves to operate muscles so the syndrome affects how this works. When this network starts to malfunction in the body, the fingers and toes are affected first as the signals have greater difficulty reaching them because they are further away. The antibodies start to destroy the myelin insulation around the axons that assists with neural conduction. The axons themselves, which communicate the nervous system messages, can also be damaged.

The syndrome varies in different patients

The syndrome has several subtypes which are characterized by affecting different combinations of symptoms. For example, acute inflammatory demyelinating polyneuropathy (AIDP) can result in muscle weakness, sensory problems, cranial issues, sensory symptoms, nerve weakness and autonomic involvement. Miller Fischer syndrome, another type of Guillain-Barré syndrome, can result in ataxia, areflexia and eye muscle weakness.

How common is the syndrome?

The syndrome can affect anyone but it is more likely to attack people as they age. With every 10 years rise in age, the risk of the syndrome increases by 20%. There are between 0.89 and 1.89 cases per 100,000 people. The syndrome tends to affect approximately 1,200 people in the United Kingdom every year. The risk of the syndrome is 1.78 times greater for men versus women.

Discovery

The syndrome was first highlighted by Jean-Baptiste Octave-Landry in 1859. Then in 1916, Jean Alexandre Barré, Georg Guillain and Andre Struhl recognized the condition in two soldiers.

References:

Further reading

The Lancet, Guillain-Barré Syndrome outbreak associated with Zika virus infection in French Polynesia: a case-control study: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)00562-6/abstract

Last Updated: May 16, 2016

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