Guillain-Barre syndrome (GBS) was first described by French physician Jean Baptiste Octave Landry de Thézillat in 1859, but remained undiagnosed until 1916. GBS affects all ages, races, and sexes around the world, but Guillain-Barre affects fifty to sixty percent more Caucasians than African Americans. The average age of onset is thirty to fifty. The incidence of Guillain-Barre syndrome in the general population is one person in 100,000.
Guillain-Barre is classified as an auto-immune disease, meaning that the body forms T-cells or antibodies that attack molecules, cells, or tissues of the patient. GBS is usually triggered by an acute infection two weeks prior to the onset of symptoms.
GBS is marked by an ascending paralysis causing loss of motor function, sometimes including the respiratory muscles. Patients may feel stiffness and pain in the back, hips, thighs, and calves before the paralysis begins. If treatment is not administered, the disease can produce fatal effects.
A feeling of “rubbery legs” is often described as an early symptom of GBS. Most patients require hospitalization and 30% require some form of airway intervention due to paralysis of the respiratory muscles.
Guillain-Barre is divided into three progressive stages:
The first stage lasts from twenty-four hours up to three weeks. This stage is characterized by a rapid onset of paralysis and muscle weakness, with little or no muscle atrophy. Patients may notice difficulty breathing and sometimes require an emergency intubation.
Stage two is called the plateau stage. This is when the symptoms are the most severe for the patient, but have stopped progressing. This stage lasts from two to fourteen days. When symptoms persist throughout this stage, the patient may become discouraged.
Stage three is the recovery stage. This stage lasts from six months to two years, but most patients completely recover within a few months to a year. The symptoms slowly disappear during the recovery phase of GBS.
For a diagnosis of GBS certain criteria must be met. The patient must have progressive, relatively symmetrical weakness of two or more limbs due to neuropathy. Their disease must not have continued for longer than four weeks. Other causes of symptoms must first be excluded.
Patients with Guillain-Barre patients are partially or completely dependent for all their needs, due to sensorimotor loss. Patients often are fearful and anxious about their pending recovery. This makes supportive care and monitoring of all vital functions important factors in the recovery process.
Recovery from Guillain-Barre can last from weeks to months and some patients may still require around the clock care. Physical therapy and speech therapy are common in the months following discharge. Approximately 80% of patients completely recover within months after the disease process takes over their body.
GBS is a curable disease if early intervention is sought. In third world countries the death rate rises to 4% because of the lack of lifesaving equipment. Guillain-Barre is still not understood fully and every case is a learning experience for physicians and medical staff.