GUILLAIN – BARRÉ SYNDROME(GBS)
Guillain-Barre Syndrome(GBS) , is an acute, immune-mediated disorder of peripheral nerves, spinal roots, and cranial nerves, commonly presenting as a rapidly progressive, are flexive, relatively symmetric ascending weakness of the limb, truncal, respiratory, pharyngeal, and facial musculature, with variable sensory and autonomic dysfunction.
An interesting fact is that, recent reports reveal that U.S. President, Franklin D. Roosevelt was not paralyzed because of polio, but by GBS.The reported incidence rates for GBS are 1–2 per 100,000 populations. The lifetime likelihood of any individual acquiring GBS is 1:1000.
The exact etiology of GBS is unknown.
In GBS, the myelin sheath becomes damaged, causing nerve damage, resulting in
faulty sending of signals between nerves and muscles. This faulty
wiring causes muscle weakness, numbness and
tingling, and eventually paralysis. There is more commonly symmetrical weakness
in the lower limbs initially, which rapidly progress in an ascending fashion. Surgery, childbirth or
vaccinations may also trigger the syndrome.
Symptoms include pain
in spine and limbs,instability,
dysesthesias, numbness or tingling, muscle weakness, which gets progressively
worse,respiratory problems etc. Patients often complain of rubbery
legs reflexes, weakness
and tingling sensation in legs,severe pain in lower back possibly spreading to
upper body and arms, weakness in breathing,and in extreme cases,
paralysis. Diagnosis includes exam,
electromyography nerve conduction velocity test,spinal tap (lumbar puncture) and blood tests.
In treatment for GBS,not all treatments and therapies
may be indicated. Intravenous immunoglobulin (IVIg)-at a starting dose of 2 grams per kg of
patient weight, may be given in 5 divided dosages over 5 days. Concentrated antibodies taken from
healthy donors can be administered as they can block and destroy the harmful
antibodies that are attacking the nerves. Plasmapheresis aims to remove the cells that are attacking the nerves. Pain medications such as naproxen, Ibuprofen, aspirin,
acetaminophen, tramadol, pentazocine etc are given to relieve the patients
from severe pain. Physical therapy, speech therapy, supportive therapy and
ventilator services are provided to the patients if needed. Safety measures
should be taken for compensating the loss of sensation.
BELSY BOBAN
PHARM D 4TH YEAR
