Guillain-Barre Syndrome - Treatment

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How is Guillain-Barré syndrome treated?

There is no known cure for Guillain-Barré syndrome. However, there are therapies that lessen the severity of the illness and accelerate the recovery in most patients. There are also a number of ways to treat the complications of the disease.

Currently, plasma exchange (sometimes called plasmapheresis) and high-dose immunoglobulin therapy are used. Both of them are equally effective, but immunoglobulin is easier to administer. Plasma exchange is a method by which whole blood is removed from the body and processed so that the red and white blood cells are separated from the plasma, or liquid portion of the blood. The blood cells are then returned to the patient without the plasma, which the body quickly replaces. Scientists still don't know exactly why plasma exchange works, but the technique seems to reduce the severity and duration of the Guillain-Barré episode. This may be because the plasma portion of the blood contains elements of the immune system that may be toxic to the myelin.

In high-dose immunoglobulin therapy, doctors give intravenous injections of the proteins that, in small quantities, the immune system uses naturally to attack invading organisms. Investigators have found that giving high doses of these immunoglobulins, derived from a pool of thousands of normal donors, to Guillain-Barré patients can lessen the immune attack on the nervous system. Investigators don't know why or how this works, although several hypotheses have been proposed.

The use of steroid hormones has also been tried as a way to reduce the severity of Guillain-Barré, but controlled clinical trials have demonstrated that this treatment not only is not effective but may even have a deleterious effect on the disease.

The most critical part of the treatment for this syndrome consists of keeping the patient's body functioning during recovery of the nervous system. This can sometimes require placing the patient on a respirator, a heart monitor, or other machines that assist body function. The need for this sophisticated machinery is one reason why Guillain-Barré syndrome patients are usually treated in hospitals, often in an intensive care ward. In the hospital, doctors can also look for and treat the many problems that can afflict any paralyzed patient - complications such as pneumonia or bed sores.

Often, even before recovery begins, caregivers may be instructed to manually move the patient's limbs to help keep the muscles flexible and strong. Later, as the patient begins to recover limb control, physical therapy begins. Carefully planned clinical trials of new and experimental therapies are the key to improving the treatment of patients with Guillain-Barré syndrome. Such clinical trials begin with the research of basic and clinical scientists who, working with clinicians, identify new approaches to treating patients with the disease.

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See what others are saying

Comment from: skeet, 35-44 Male (Patient) Published: August 12

The year was 1988. I was 10 years old when I was diagnosed with GBS. I had the flu two weeks prior to being diagnosed with GBS. Everything was fine until I awoke with no leg movement. I didn't feel any tingling or pain anywhere, it just happened. My mother took me to the hospital. That's where I started to lose muscle strength in my hands and arms. It was like my body had shut down. Hours had gone by when all of a sudden I stopped breathing on my own. I was placed in the ICU for two months and later put on the regular floor in the hospital where I started PT and OT therapy. I was in a wheelchair for three and a half years. The hospital gave me steroids as treatment while I was in the hospital and did a plasma exchange. I have about 70% of my muscle strength back. I have back, leg, and hand pain. I walk with a gait. I used to be left-handed, and now I write with my right hand. It's been a long road. I am taking it one day at time. All can say is keep moving.

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Comment from: Aloha27, 55-64 Male (Patient) Published: November 20

I was hit with GBS (Guillain-Barre syndrome) in late March 2013. The first symptom I noticed was a sensitivity to sunlight, which I incorrectly attributed to be a side effect of doxycycline, prescribed for a minor upper respiratory infection. Tingling in the toes and legs rapidly progressed to my trunk and I developed severe ataxia in my legs to the point I could not walk or stand. Breathing became more difficult and I could not take a deep breath without difficulty. Paramedics were called and the attending medic radioed ahead to the hospital to give them a heads-up that we were inbound and GBS was suspected. IVIG (intravenous immunoglobulin) was administered within 3 hours of being admitted and I spent two weeks in ICU (intensive care unit) before transfer to the ward. An odd effect of the syndrome is that my sense of taste was pretty much destroyed. Nothing, but noting tasted as it should have. After three weeks in hospital I was transferred to a RCU (recovery care unit) facility where I remained for about 4 weeks. Physiotherapy was begun, my upper body strength and coordination recovered very rapidly and I learned to walk with a walker although I was still dependent on a wheelchair to get around. As my spouse is a paramedic and her sister a nurse, the doctor at the RCU allowed me to be sprung on May 17th. I used the wheelchair until the middle of July, as I had lost over 35 pounds of muscle due to atrophy, mostly in the legs. I'm still using a cane for walks of over 100 meters but my balance has improved. There is still tingling in the toes of both feet. A pronounced foot drop of the left leg appears to be the last symptom I'll have to deal with.

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