Guillain-Barré Syndrome: A Look at the Causes, Symptoms, Treatment, Risks & Complications

Can Zika virus cause Guillain-Barré Syndrome? What about the risk of paralysis? Read this article to find answers to the common questions about this dreaded disease.  

The concern for Guillain-Barré syndrome (GBS) has risen sharply in the last few years owing to its link with Zika virus infection. Does it mean only Zika virus infection can cause Guillain-Barré syndrome? No, many other causes can possibly lead to GBS.

One study in the Journal of Neurology, Neurosurgery & Psychiatry suggests that out of every 100,000 persons with Zika virus infection, nearly 24 cases of GBS are observed.

Guillain-Barré Syndrome: A Quick Overview

Guillain-Barré syndrome is a rare autoimmune disease that causes numbness, pain, and weakness in the extremities. As the disease progresses, it may cause paralysis of the whole body.

An autoimmune disease is a condition in which the body’s immune system attacks healthy cells and tissues in the body. In the case of Guillain-Barré syndrome, the nerves are the target of the immune system.

No one knows the cause of Guillain-Barre syndrome. However, many persons who develop the disease report having a respiratory infection or the stomach flu several days or weeks before they experience the first symptoms of Guillain-Barré syndrome.

No cure is currently available but the available treatments can improve symptoms. In fact, most people recover completely within months. However, in some people, chronic effects such as weakness, numbness, and fatigue may linger for years.

Types of Guillain-Barre Syndrome include:

• Acute inflammatory demyelinating polyradiculoneuropathy (AIDP), the most common type in the U.S.
• Miller Fisher syndrome (MFS) is less common in the US. It affects nearly 5 percent of the people with GBS. MFS patients have paralysis in the eyes as the first symptom.
• Acute motor axonal neuropathy (AMAN) and acute motor-sensory axonal neuropathy (AMSAN).

What causes Guillain-Barré syndrome?

The exact cause of Guillain-Barré syndrome is not clear. About 66 percent of patients report having diarrhea or a respiratory illness several days or weeks prior to developing the symptoms of GBS.

One of the most common illnesses that precede GBS is Campylobacteriosis, which is a diarrheal illness caused by the bacterium Campylobacter jejuni. Other infections preceding GBS are the flu and viral infections due to cytomegalovirus and Epstein Barr virus.

Very rarely, people may develop the symptoms of Guillain-Barré syndrome after they receive the flu vaccine or the HPV vaccine. In addition, Zika virus infection has also been linked to an increased risk of GBS.

Symptoms of Guillain-Barré syndrome

The early symptoms of Guillain-Barré syndrome usually start in the fingers, toes, ankles or wrists and gradually spread to the legs and arms. This might take a few hours to a few days. These can include:

• Numbness
• Prickling, pins, and needles
• Muscle weakness that starts in the legs and spreads to the upper body
• Difficulties with balance and coordination

Over the next few days to weeks, the symptoms may progress to –

• Problems with breathing
• Having problems with unaided walking
• Paralysis of the legs, arms and/or face
• Visions problems, such as blurry or double vision
• Problems with chewing, speaking or swallowing
• Impaired control over bladder and bowel functions
• Severe achy pain that might become worse at night
• Abnormally fast heartbeats
• Changes in blood pressure

These symptoms usually peak within thirty days and may improve after a period of a plateau. A plateau is a duration in which the symptoms neither become worse nor improve.

Treatment of Guillain-Barré syndrome

Treatments do not cure Guillain-Barré syndrome but help reduce disease severity and shorten the duration of the illness. They should begin immediately after the diagnosis is confirmed.

Plasmapheresis

Also called plasma exchange, this treatment procedure clears your blood of the antibodies that attack your nerves. Once the blood is clean, it is returned to your body.

Intravenous immunoglobulin

Immunoglobulins are antibodies obtained from a donor. When high doses of immunoglobulins are injected into the body, they can help block the patient’s antibodies from damaging the nerves.

In addition, your doctor may recommend treatments to:

• Relieve pain and prevent blood clots
• Improve mobility, such as a wheelchair or braces
• Regain muscle strength and flexibility. These include several sessions of physical therapy.

Complications of Guillain-Barré syndrome

Nerve damages due to Guillain-Barré syndrome can leave a widespread effect on your movement and the functions of major organs such as the heart, bladder etc.

As the disease progresses, the effects on the nerves become more prominent that can potentially lead to:

Breathing problems

Breathing problems occur when the respiratory muscles become affected. Weak respiratory muscles cannot support normal breathing and you may need to use a respirator to support your breathing.

Chronic abnormal sensations

Though most people recover completely, some may continue to have weakness, numbness or tingling.

Abnormal Heart Rhythms and blood pressure problems

Patients may experience high or low blood pressure as well as irregular heartbeats.

Pain

Nearly 50 percent of the people with Guillain-Barre syndrome experience severe nerve pain. Medications can help relieve the pain.

Constipation and Urine Retention

Damages to the nerves that control the functions of the bowel and bladder become affected can lead to constipation and urine retention.

Blood clots and bedsores

Reduced mobility due to paralysis can cause pressure sores and blood clots.

Guillain-Barré Syndrome Interesting Facts

• GBS is a rare autoimmune disease in which a person’s own immune system destroys healthy nerves that lie outside of the brain and the spinal cord.
• It affects approximately 1 out of every 100,000 people in the United States. In a given year, an estimated 100,000 people develop GBS.
• 80 to 160 new cases are reported each week.
• Approximately 85% of patients are able to walk without any support within six months of recovery. However, less than 20 percent have significant problems with mobility even if they have received standard treatment.
• Death occurs in 1 to 18 percent of patients due to complications such as pneumonia, serious infections (sepsis), and respiratory problems.
• Pain, fatigue, and abnormal sensations in the limbs may continue for years following recovery.
• In most cases, a diagnosis is made based on the signs and symptoms. Less commonly, a doctor may ask for tests that measure electrical activity in the muscles, such as electromyography and nerve conduction studies.
• Up to 70 percent of patients report preceding infections, mostly an infection by Campylobacter jejuni.
• The medical cost of GBS treatment per patient can reach up to $318,966.
• A relapse may occur in about 3 percent of patients.