Guillain-Barré syndrome is an acute autoimmune disease marked by inflammation of the peripheral nerves affecting the arms and legs. It involves destruction of the myelin sheath surrounding the largest sensory and motor fibers, resulting in weakness and disrupted proprioception. While the cause is unknown, it is thought to be an inappropriate immune response, possibly linked to certain vaccines. It affects about 2 per 100,000 people annually in a nondiscriminatory manner. Signs and symptoms include numbness, tingling, muscle weakness and diminished reflexes that progress distally. Most patients experience complete recovery within 2 months to 2 years through intravenous immunoglobin therapy or plasmapheresis.
2. DESCRIPTION
Acute autoimmune disease marked by inflammation of the
peripheral nerves, affecting arms and legs
Involves destruction of the myelin sheath surrounding
largest, most myelinated sensory and motor fibers, resulting
in disrupted proprioception and weakness.
4. INCIDENCE &
PREVALENCE
GBS affects 2 per 100,000 annually (1,500 people/year)
Nondiscriminatory: can affect persons of any gender, age, or
ethnic background
5. SIGNS AND SYMPTOMS
Numbness and tingling in hands and feet
Distal progression: muscle weakness, diminished reflexes
and proprioception, decreased sensation
For some, progresses to trunk, face, and cranial nerves,
resulting in difficulty swallowing, chewing, speaking, and
facial expressions
Deep, aching pain/hypersensitivity to touch
Respiratory/cardiac dysfunction and failure
6. COURSE/PROGNOSIS
80% experience complete recovery
Recovery may last from 2 months to 2 years
3 distinct phases:
Acute (4 wks) - initial rapid onset of symptoms
Plateu (few days to few weeks) - symptoms neither
worsen nor improve
Recovery - gradual improvement
7. DIAGNOSIS
Diagnostic testing for GBS includes
Physical and neurological exam
Lumbar puncture
Computed Tomography (CT) scan
8. MEDICAL/SURGICAL
MANAGEMENT
Intravenous immunoglobin therapy: prevents immune
system from further attacking Schwann cells and myelin by
blocking receptors on microphages
Plasmapheresis: filters blood plasma to remove
antibodies and aids in replacing lost fluids
Corticosteroids: inhibit inflammation associated w/
symptoms
9. IMPACT ON CLIENT
Limited physical mobility
Inability to engage in meaningful occupations because of
pain, extreme muscle weakness in arms and legs, and fatigue
Sensory functions impaired
Using cultural contexts to structure intervention activities
10. REFERENCES
Guillain-Barré Syndrome Support Group (2009) A Quick Guide to Guillain-Barré Syndrome and
CIDP. Guillain-Barré Support Group, Sleaford.
Little evidence that supports a causal link between most vaccines and Guillain-Barre syndrome.
(2009). Drugs & Therapy Perspectives, 25(11), 21-23.
Lugg, J. (2010). Recognising and managing Guillain-Barre syndrome. Emergency Nurse, 18(3),
27-30.
Lundy-Ekman, L. (2007). Neuroscience: fundamentals for rehabilitation (3rd ed.). St. Louis,
Mo.: Saunders/Elsevier.