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    Guillain-Barre Syndrome: Mechanisms, Risk Factors, and Comprehensive Management 

                          

By Dr. Keerthi Kundana Consultant Pediatric Neurologist, Ankura Hospital for Women and Children

Guillain-Barre syndrome (GBS) is a rare condition that causes sudden muscle weakness affecting most of the body.

What is Guillain-Barre Syndrome?

Guillain-Barre syndrome (GBS), also known as acute inflammatory demyelinating polyradiculoneuropathy (AIDP), is a neurological disorder where the body's immune system responds abnormally and attacks peripheral nervous system—the network of nerves outside the brain and spinal cord.

As a result, the nerves cannot transmit signals effectively and the muscles begin to lose their ability to respond to the brain's commands, which causes weakness and abnormal or absent reflexes.

The condition can arise suddenly and requires immediate hospitalization. Symptoms may worsen over a few days or take several weeks to worsen, with the most severe weakness usually occurring within the first two weeks of onset.

Muscle weakness, pain in limbs, tingling, and numbness are some of the symptoms that can progress into paralysis. However, the majority of patients recover completely from the illness with treatment.

Who is at an increased risk of developing Guillain-Barre Syndrome?

This syndrome, Guillain-Barre syndrome, can occur in anyone, in children or adults.

Symptoms of Guillain-Barre Syndrome

Although Guillain-Barre syndrome (GBS) symptoms might differ from person to person, some typical indicators are as follows:

• A tingling or weakness that starts in the legs and spreads to the arms and upper body.

•  severe pain in the legs or back

• A neurological exam reveals a loss of deep tendon reflexes.

The condition may worsen to cause muscle paralysis, breathing difficulties, and problems with blood pressure and heart rate. GBS is a medical emergency and needs immediate treatment.

The condition can be fatal in extreme cases, but most people recover significantly. Some will experience chronic fatigue, pain, or muscle weakness, and around 3 out of 20 will require long-term assistance with mobility. Since GBS symptoms mimic many other diseases, a diagnosis by a health care provider is crucial.

Guillain-Barre syndrome is a rare condition with an unknown exact cause. However, in about two-thirds of cases, individuals experience an infection within the six weeks before symptoms appear. These infections may affect the respiratory or gastrointestinal system and can include illnesses like COVID-19.

 What is the cause behind the surge in Pune?

The surge in Pune is being linked to Campylobacter jejuni, a major cause of food borne infections and a leading trigger of Guillain-Barre syndrome (GBS) worldwide, according to a BBC report.

The connection between this pathogen and GBS was first identified in the 1990s in rural China, where it was commonly found in chickens. Experts observed that GBS outbreaks occurred during the monsoon season as children came into contact with water contaminated by chicken or duck droppings.

While undercooked poultry is the most common source of Campylobacter jejuni infections globally, experts note that it can also spread through contaminated water, similar to diseases like cholera or salmonella.

 Can Guillain-Barre Syndrome Be Prevented?

In most cases, Guillain-Barre syndrome cannot be prevented. Researchers are still uncertain why some individuals develop GBS after an illness while others do not. However, maintaining overall health may help reduce the risk. Here are some steps that may be beneficial:

            •Wash your hands frequently.

            •Avoid close contact with individuals who have stomach flu or other infections.

            •Maintain a healthy diet and exercise regularly to support your immune system.

            •Regularly clean and disinfect frequently touched surfaces like tables, toys, door     handles, phones, and bathroom fixtures.

            •Stay updated with recommended vaccinations.

 Treatment

The treatment is targeted to halt the progression of weakness and accelerate recovery. While most individuals make a full recovery, severe cases can be life-threatening. Although the recovery process can take several years, many people regain the ability to walk within six months of symptom onset. However, some may experience long-term effects such as weakness, numbness, or fatigue.

The treatment includes giving IVIG injections (Intravenous Immunoglobulin) or plasmapheresis. The earlier the treatment is started, better is the recovery. Good supportive care with adequate nutrition, Physiotherapy, prevention of bed sores, prevention of infections, prevention of deep venous thrombosis forms an important part of the treatment process. Sometimes prolonged ventilator support may also be needed.

Conclusion

Guillain-Barre syndrome (GBS) is a very severe condition that can lead to sudden health complications. The good news is that with appropriate treatment, most people recover well, though the journey can be long and challenging. While the recovery process may feel daunting, your healthcare team will be there to guide and support you.