Guillain Barre Syndrome Essay

1653 words - 7 pages

Guillain-Barre Syndrome

Guillain-Barre Syndrome, or acute inflammatory demyelinating polyneuropathy, is a self-limiting disease characterized by areflexia and acute progressive motor weakness of at least one limb. Other symptoms include motor weakness of the extremities and face, loss or reduction of deep tendon reflexes, decreased sensation throughout the body,ophthalmoplegia, and ataxia. In severe cases respiratory failure and autonomic dysfunction may occur. Respiratory failure results from the demyelination of the phrenic and intercostal nerves. Consequently, the person loses the ability to inhale and exhale. Autonomic dysfunction resulting from the demyelination of the sympathetic and vagus nerves can lead to cardiac arrhythmias, tachycardia, postural hypotension, and hypertension. Analysis of the cerebral spinal fluid (CSF) shows increased protein concentration with few cells. Other tests reveal a decreased nerve conduction velocity resulting from segmental demyelination with mononuclear cell infiltration.

In 70% of the afflicted individuals, the symptoms of Guillain-Barre Syndrome (GBS) occur within two weeks following infection. Clinical diagnosis is based on the presence of albumino-cytological dissociation in the CSF. Following the onset, motor weakness progressively deteriorates for four weeks and may lead to respiratory failure and cardiac instability. If either respiratory failure or cardiac abnormalities occur, the patient will be placed in the intensive care unit and closely monitored. Eventually the person's condition will cease to deteriorate, and he/she will enter a plateau period of two to four weeks during which little or no change will occur. Following the plateau stage, the patient will gradually recover. The mean recovery time to independent walking is 85 days, if the person is not on a respirator. If he/she was on a respirator, the mean time doubles to 169 days. The affected individual can usually expect a full recovery; however, some are left with a residual deficit after one year.

0.6 to 1.9 persons per 100,000 people are afflicted with GBS each year. The disease occurs worldwide and can strike anyone. Recent data has shown that white Caucasian males between the ages of 16 to 25 and 45 to 60 are the most prone. 15 to 20% of GBS patients require some form of mechanical ventilation during the course of the disease. Although mortality rate is 2.4 to 6.4%, there is an 80% recovery. Despite the high recovery rate, 15% of the survivors retain some disability.

90% of GBS patients had a viral-like illness and 4.5% received vaccinations within one month of the onset. Most of the illnesses preceding GBS were caused by cytomegalovirus and Epstein-Barr viruses. Strong correlations also occurred with Campylobacter jejuni infections, Lyme disease, and AIDS. IgM and IgG antibodies to C. jejuni were detected in 15 of 38 GBS patients. Of the individuals that contracted GBS following vaccinations, the swine flu vaccine of...

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