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Guillain Barre Syndrome

06 Dec 2021

Here’s some info I gathered up for a school project! This is a really fascinating neurological disease so I hope you all enjoy reading about it.

Guillain-Barré syndrome (GBS) is a neurological autoimmune disease of the peripheral nervous system. It is usually triggered by anything that can elicit an immune response, including bacterial or viral infection or vaccination. Triggers are generally respiratory or gastrointestinal infections. An antibody-mediated attack to the Schwann cells causes destruction of the myelin sheath, which reduces the speed of neural impulses and can lead to damage to the axon itself.

Initial symptoms include numbness, tingling, muscle weakness, pain and coordination difficulties. In the hours, days or even weeks after the onset of these, further symptoms can include paralysis of various body parts, problems speaking, chewing or breathing, visual distortion and issues with defecation and urination alongside moderate to severe pain. Symptoms will then stabilise for weeks or months before gradually improving.

A diagram showing the various manifestations.

Diagnosing the syndrome requires testing for loss of deep tendon reflexes, and also a nerve conduction velocity test as the speed with which signals are transmitted is usually reduced. The muscle weakness is also symmetrical which can aid in ruling out other disorders, as can checking the speed of onset.

Intravenous immunoglobulin is the most common treatment for GBS, in order to regulate the immune system. Plasmapheresis (plasma exchange) is also sometimes used. Depending on the patient and variation, various other treatments including ventilation may be necessary. Recovery can take a year, and one in five patients is left with long term difficulty. Death rate is 7.5%.

There is a lot of worry amongst vaccine hesitant and anti-vaccine people that vaccinations, including covid-19 vaccines, cause an increased incidence of GBS. In terms of the influenza vaccine, there has been a recorded increase in the number of cases of GBS by 1 or 2 cases per million after the seasonal flu vaccine program. However, this is lower than the number of GBS cases caused by catching the flu under normal circumstances. Though there has been little research into it, evidence suggests that the same is true for covid-19.

Sources:

Note: This page was created before I knew how to cite sources properly. It’s not quite bad enough for me to justify going through and putting everything in APA format and working out where to put in in-text citations at 1am as I am writing this, but it’s on the to-do list.

Image from Wikimedia Commons, by Leonarhard, S.E., Mandarakas, M.R., Gondim, F.A.A. et al under a CC-BY-4.0 license.

The UK Government

The NHS

The USA National Institute of Neurological Disorders and Stroke

The WHO

Mayo Clinic