GBS : Guillain–Barré syndrome, a virus that can destroy your system

Highlight:-

  • GBS is a serious and rare disease autoimmune disease that attacks our peripheral nervous system
  • GBS can affect anyone, regardless of their age, sex
  • In 20-30 percent of cases, chest muscles are affected which makes it tougher for the patients to breath
  • The risk of GBS increases with the increase in age

 

Humans and viruses have had a unique relationship over the years that they have co-existed, and humans are generally confident and calm when they are facing a viral infection, even though whenever a new virus is found it proves disastrous for the people, soon the medications are developed and the viruses have a minimalistic effect on our life. Although the current trending virus is the coronavirus, GBS is the virus that is far more dangerous and can literally leave our body with crippling results. This virus has the power and potential to pit our own body’s immune system against us.

What is Guillain–Barré syndrome?

GBS is a serious and rare disease autoimmune disease that attacks our peripheral nervous system, this disease is so severe that it affects our body, it can lead to weakness and result in paralysis, the worst thing being, and this disease could last for months and in fewer cases can live with you for years. GBS is deadly and has a fatality rate of 3-5%.

Who can be affected by Guillain–Barré syndrome?

GBS can affect anyone, regardless of their age, sex. Although this disease is more common in older people and males, this condition is very rare and affects only 1 out of 100,000 humans. This condition is generally developed after an infectious disease.

How does Guillain–Barré syndrome attack us?

The cause of how this affects the human body is unknown, but it is a follow up of a bacterial infection in our body. GBS can attack and affect any part of the nervous system except for the brain and the spinal cord, an autoimmune disease means that our immune system attacks a particular group of healthy cells, in most of the cases they attack the myelin cells, as the myelin cells are affected or destroyed nerves are no longer able to establish a connection or send messages to our brain, such as a touch sensation, etc., this lack of communication results in weakening of the muscles.

What are the symptoms of Guillain–Barré syndrome?

The disease mostly starts with a tingling sensation in the body, majorly starting from tingling and weakness in feet and legs, it slowly makes its way in our body, the virus starts spreading from the legs towards the upper body. The nerves connecting the lowest extreme part of our bodies to the brain are the longest and thus can face obstruction or breakage due to the symptoms of DBS

Symptoms and other complications include?

  • Weakness in the lower body muscles starts moving upward
  • Lack of balance or instability when walking
  • Bad coordination of facial muscles during daily activities such as chewing or talking
  • Strong cramp-like pain, that gets worst as the night progresses
  • Bad bladder control, in inefficient bowel storage
  • Severe nerve pain, which may signify the need for effective and quick drug management
  • Considerable increase in the heart rate
  • Change in blood pressure, mostly high but at times can lead to low blood pressure
  • Development of new blood clots
  • Strong increase in the body ache if the person is immobile for a considerably long duration
  • Uneasy feeling or difficulty breathing
  • In 20-30 percent of cases, chest muscles are affected which makes it tougher for the patients to breath
  • Difficulty reading, learning or understanding anything new

When should you approach a doctor?

You do not need to worry about this disease if you have a mild tingling sensation in your hands or feet and it does not move upwards and instead stays limited only to that spot or that part of your body. You might have to be aware and be swift to book an appointment with your doctor if:-

  • Tingling that originally started in your feet or toes and is now slowly moving up your body.
  • You are noticing tingling or weakness that’s spreading through your body rapidly.
  • Developing difficulties while breathing or getting caught short of breath when lying flat
  • Unable to work with your saliva or gulp, instead you start choking on your saliva (People who have issue gulping saliva are treated as severe cases, and they need to be admitted in the Intense Cure Unit, as at this condition GBS can turn life threating)
  • Guillain-Barré syndrome is an extremely serious condition that our body deals with, it requires immediate hospitalization as the condition can worsen rapidly.
  • Be quick to analyze your problems and report to the doctor as the sooner correct treatment is received, more are the chance of a better and strong comeback.

What are the common causes of Guillain–Barré Syndrome?

GBS does not have any particular cause but there are some situations or conditions that may signify that you are getting infected by the GBS, the risk of GBS increases with the increase in age, males are more prone to GBS as compared to females. A bacterial infection causing food poisoning is the most common disease before getting infected by GBS. Sometimes GBS can follow HIV or EBV, GBS is also known to affect the human being who has recently fought against Mycoplasma Pneumonia (A bacterial infection for the lungs).

Few surgeries are also known to trigger GBS in the human body, while the immune system cancer can be a strong point that leads to the cause of this situation, in rare cases, it has been found Flu vaccination or childhood vaccination can also lead to GBS.

What can the Guillain–Barré Syndrome be triggered by?

There can be various infections that can trigger GBS, but the most common reasons that trigger GBS are:-

  • If a person was infected with campylobacter, this is a type of bacteria that I very commonly found in undercooked poultry
  • If the patient was previously infected by the Influenza virus
  • During the cases of Zika virus, it was observed that the number of GBS cases was on a rise, so it was assumed that post-Zika virus relief, a human can develop GBS,
  • If the human suffered due to Hepatitis A, B, C and E
  • Cases with HIV, the virus that causes AIDS are also commonly linked with triggering GBS
  • Mycoplasma pneumonia
  • Surgery can use a trauma or as an aftereffect of the surgery GBS can be triggered in your body
  • Hodgkin’s lymphoma

 

Controversies around Guillain–Barré syndrome?

Firstly during the 1976 swine flu outbreak, it was noticed that there was a small increase in the cases of GBS after the vaccination, however, the increase was not significant, as the cases went up by 1 in 100,000. But later research was conducted, which clearly denoted the risk of developing GBS was way higher due to flu as compared to the vaccination.

The center of disease control and prevention passed out a statement claiming it is important to realize and remember, that there are several diseases related to influenza, and it’s better to stick to the vaccinations to prevent the risk of complications and mutations

Diagnosis of Guillain–Barré syndrome?

As the design structure of GBS is very complicated it is very hard to diagnose GBS, especially in its early stages. The symptoms of GBS vary from people to people and the symptoms are very common to regular pain, or small-mild diseases and other neurological diseases. When being inspected doctor would first check if the weakness is similar on both sides as this is the first give away of GBS.

The inspection is further continued, by checking for the rapid onsets, other neurological conditions are very slow to react and affect our bodies if the onset is noticed to be quick, majority of the times it denotes towards infection of GBS.

Tests used to diagnose Guillain–Barré syndrome?

Primary diagnosis is conducted on a physical scale, although if the results of physical tests aren’t conclusive, doctors recommend one of these tests:-

  • Nerve conduction exam: In this test, electrodes are taped to the skin, and the testing for speed of nerve signal is conducted, this test is conducted by passing small waves of shock with the nerves through the skin, if the person is affected by GBS the signals travel slower along the nerves as compared to the healthy human being
  • Electromyography (EMG): In this condition, thin strong and pointy (Needle-like) electrodes are used to poke the muscle fibers to test the nerve functioning.
  • Spinal tap: this condition is also commonly known as a lumbar puncture, in this test CSF (Cerebrospinal fluid) is extracted from the spinal canal and is then tested in the laboratories for the sign of any disease, people with GBS generally tend to have more protein in their CSF.

Types of Guillain–Barré syndrome

  • Acute inflammatory demyelinating polyradiculoneuropathy (AIDP): One of the most common types found throughout the world, this is particularly common in the United States, in this category, the virus begins in the lower part of the body and slowly spreads through the other body parts.
  • Miller Fisher syndrome (MFS): This is the second type of GBS, this is rare in the United States sitting at 5 to 10 percent amongst GBS, although this type is very common in Asia, and in this condition, paralysis starts with the eyes and spread through the body developing problems with walking are common.
  • Acute motor axonal neuropathy (AMAN): This condition is also known as acute motor-sensory axonal neuropathy (AMSAN), these conditions are very rare in the United States but is extremely common in Japan, China, and Mexico.

Treatment for Guillain–Barré syndrome  

There is no proper treatment available for GBS, meaning that this infection cannot be completely eradicated from your body. But there are solutions available that can help ease the symptoms. There are two main types of treatment available that can reduce the severity of symptoms or help speed up the recovery process.

  1. Immunoglobulin therapy: This treatment is processed in the form of (IV) Intravenously. This helps reduce the autoimmune response drastically and reduce the attacks on the system.
  2. plasmapheresis: This process is also known as plasma exchange, blood is separated from the body and then the blood plasma is separated from the blood cells, then the blood cells are reinfused in the body, and the body regenerates the plasma, this process helps redevelop healthy cells by eliminating antibodies.

Recovery time from Guillain–Barré syndrome

In most common cases, the nerve damage worsens quickly and keeps deteriorating for two to four weeks, and the deteriorating stops by the 4th week, the average recovery time generally ranges from 6 to 12 months. The recovery process can be very slow and daunting, it requires a lot of support, psychotherapy, and counseling, etc. there is no assurance of everything being normal post the recovery period. A few patients face long-term disability post-treatment, and thirty percent of recovered patients, feel the weakness even after 3 years of the disease.

How and when the patient recovers, depends completely on the patient’s body, some may require a decade to get out of this disease, Patients generally recover at different rates, and a few patients experience incomplete or delayed recovery. Although most patients recover fully even after most serious cases of GBS.

Measures taken by WHO to counter Guillain–Barré syndrome

To deal with the latest development in the GBS disease, that is to avoid a surge in the number of infected individuals, WHO is supporting countries to manage GBS by of Zika virus infection, the measures implemented by WHO are:-

  • Detailed surveillance of GBS in Zika affected nations
  • Providing the countries with guidelines for targeted assessment and detailed management of GBS.
  • Helping those countries to implement WHO guidelines and enhance health systems to advance the management of GBS cases and spread awareness amongst the people.
  • WHO has also allocated special budget, to understand, research and develop better ways to fight GBS

Recent developments regarding Guillain–Barré syndrome

Rats are used as models to test the autoimmune response, and many agents have already shown promise of improvement, an antibody is specifically targeted against the virus and it is suggested that complement inhibitors (Drugs used to treat neurological diseases) may be effective and show good results in near future.

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