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Guillain Barré Syndrome

Guillain-Barré Syndrome is a serious autoimmune disorder.  It can be triggered by several factors, including certain viruses and health conditions.  Campylobacter and Salmonella are among the leading causes of Guillain-Barré Syndrome. Both Campylobacter and Salmonella are harmful bacterium often found in undercooked poultry. In its most severe form, Guillain-Barre syndrome is a medical emergency. Most people with the condition must be hospitalized to receive treatment.

What does an autoimmune syndrome have to do with foodborne illness? You would be surprised.

What Exactly is Guillain-Barré Syndrome?

Guillain-Barré syndrome is a rare autoimmune disorder.  That’s a way of saying that the person’s own immune system turns on the body, attacking nerves.  This causes subsequent muscle weakness and sometimes even paralysis.  These symptoms can last anywhere from a few weeks up to several years.  Some people may not fully recover and suffer permanent nerve damage.  Other people may even die as a result of complications.

What Can Trigger Guillain-Barré Syndrome?

A variety of viruses and other illnesses can trigger this autoimmune syndrome.  Viruses such as: influenza, cytomegalovirus, Epstein-Barr virus, HIV, and Hepatitis viruses, A, B, C, and E.  Zika virus, caused by infected mosquitos, has also been linked to triggering Guillain-Barré syndrome.  Other illness such as: mycoplasma pneumonia, Hodgkin’s lymphoma, and even surgery have been found to be triggers for this syndrome.  In rare cases, influenza vaccines and some childhood vaccines have been found to trigger episodes of Guillain-Barré syndrome.

Campylobacter and Salmonella are among the most common causes of Guillain-Barré Syndrome.

How Common is Guillain-Barre Syndrome?

Guillain-Barre Syndrome is rare.  In the United States, it affects 1 in every 100,000 people, or about 3,000 – 6,000 Americans each year.  Men and people over the age of 50 are at a higher risk for developing Guillain-Barré syndrome.  About 1 in every 1,000 reported Campylobactercases leads to Guillain-Barré syndrome.  This translates to about 40% of Campylobactercases triggering Guillain-Barré syndrome.

What are the Symptoms of Guillain-Barré syndrome?

The onset of Guillain-Barré syndrome often starts small.  First, you might notice strange feeling in your legs. A kind of tingling sensation or some weakness.  This can spread to the upper body and to the arms.  The progression begins with tingling and may increase until some of the muscles cannot be used.  In the most serious cases, it can cause partial or full paralysis.  Symptoms can take anywhere from hours to weeks to progress.

Other symptoms may include unsteady gait or the inability to walk or climb stairs.  Some people may experience difficulty with facial or eye movements that might affect speaking, chewing, and swallowing. Muscle weakness or paralysis could also affect normal bodily functions, causing difficulty with bladder control or bowel function.  Rapid heart rate, extreme blood pressure issues, and difficulty breathing may occur.

The peak of weakness symptoms generally occurs within the first two weeks after symptom onset. Unfortunately, the recovery period is just as variable, lasting from as little as a few weeks up to a few years.

If you have recently experienced any of the risk factors such as viral illness, vaccine, or other illness known to promote Guillain-Barré syndrome, consider calling your doctor if you are now experience mild tingling sensations in your toes or fingers.  Particularly if it doesn’t seem to be spreading or worsening.  You should seek immediate medical attention if the tingling that began in the toes or feet has moved up the body, have tingling or weakness that is spreading rapidly, or having difficulty catching your breath or experience shortness of breath while lying flat.  Seek emergency medical attention if you are choking on saliva.

Do Doctors Now Why the Human Body Has This Autoimmune Response?

The specific cause of Guillain-Barré syndrome is still a medical mystery.  What is known, is that it occurs after exposure to a virus or other illnesses and creates an autoimmune response.  The immune system is designed to attack invading organisms that are harmful to our bodies.  In the case of autoimmune issues such as Guillain-Barré syndrome, the immune system attacks the protective covering of the nerves known as the myelin sheath. This damage blocks or stops the signal from the nerves to the brain, which results in the numbness, weakness, or paralysis commonly associated with Guillain-Barré syndrome.

Are There Different Types of Severity with Guillain-Barré Syndrome?

Yes. In the past, doctors thought this was a single syndrome. But modern medicine is now shown that Guillain-Barre syndrome can occur in several different forms, depending on severity. The main types that are typically observed and diagnosed are:

  • Acute inflammatory demyelinating polyradiculoneuropathy (AIDP): This isthe most common form of the syndrome diagnosed in the United States. The most common sign of AIDP is muscle weakness that starts in the lower part of your body and spreads upward to the top of the body.
  • Miller Fisher syndrome (MFS): This is a form of the syndrome whereparalysis begins in an affected person’s in the eyes. MFS is also associated with uneasy walking and gait issues. MFS occurs in about 5% of people with Guillain-Barre syndrome in the United States. However, it is more common in Asia.
  • Acute motor axonal neuropathy (AMAN) and acute motor-sensory axonal neuropathy (AMSAN): These typesare rarely observed in the United States. However, they are regularly diagnosed in several Asian countries (like China and Japan) and in Mexico.

How is Guillain-Barré Syndrome Diagnosed?

Diagnosing Guillain-Barré syndrome can be a difficult task. Signs and symptoms vary so much from person to person.  GBS can also present symptoms similar to some types of neurological disorders.  To diagnose Guillain-Barré syndrome, your doctor would most likely begin with a medical history followed by a physical exam. Diagnostic procedures may include spinal tap, electromyography, and/or nerve condition studies.

A spinal tap consists of a lower lumbar puncture.  A small sample of fluid is removed from the spinal canal in the lower back.  The fluid is analyzed for a type of change that is commonly seen in Guillain-Barré patients.

An electromyography consists of thin needle electrodes that are inserted into the muscles the doctor is needing to study.  These electrodes measure nerve activity in the muscles.  If lower activities are indicated, autoimmune action may be occurring in the nerves.

The nerve conduction studies your doctor may order consists of electrodes taped to the skin above the nerves.  In these studies, a small electric shock is passed through the nerve and the speed of nerve signals are analyzed.

Once Guillain-Barré syndrome is diagnosed, your doctor will likely begin one or more of the treatment options available.

What Are the Treatment Options?

There is no known cure for Guillain-Barré syndrome. Many people recover by waiting out the symptoms (under medical surveillance).  Some may receive treatments designed to ease symptoms or possibly reduce the duration of symptoms.  A common treatment involves a plasma exchange.  This is a procedure in which the straw-colored liquid part of the blood is removed and replaced with healthy plasma.  Other treatments can involve a high-done of immunoglobulin.  This is essentially an infusion of antibodies meant to help the body stop attacking itself.

Hospitalization is important to monitor patient conditions. Earlier treatment offers the best chance at faster recovery and minimizes complications. Complications may include respiratory distress syndrome, heart attack, and possibly death.

Guillain-Barré Outbreak?

While Guillain-Barré may appear in clusters, it is not a contagious or human-to-human transmittable illness.  Clusters often appear because the underlying causes of Guillain-Barré are often communicable illnesses.  Outbreaks of illness or foodborne illness such as Campylobacter and Salmonella, which pose a higher rate of Guillain-Barré syndrome may create a sense of Guillain-Barré syndrome outbreak, though this is not quite an accurate portrayal.

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