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General Practice 2023

SíGuillain-Barr syndromeé: what é, symptoms, causes and treatment

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SíGuillain-Barr syndromeé: what é, symptoms, causes and treatment
SíGuillain-Barr syndromeé: what é, symptoms, causes and treatment

Guillain-Barré syndrome is a serious autoimmune disease in which the immune system itself attacks nerve cells, leading to inflammation in the nerves and, consequently, weakness, tingling in the legs and arms, loss of sensation, changes in blood pressure, palpitations and muscle paralysis, which can be fatal, as it can interfere with the ability to move the respiratory muscles.

The syndrome has rapid progression and most patients are discharged after 4 weeks, however the full recovery time may take months or years. Most patients recover and walk again after 6 months to 1 year of treatment, but there are some who have greater difficulty and need about 3 years to recover.


Main symptoms

The signs and symptoms of Guillain-Barré syndrome can develop quickly and worsen over time, in some cases, leaving a person paralyzed in less than 3 days. However, not everyone develops severe symptoms, and they may experience weakness in the arms and legs. In general, the symptoms of Guillain-Barré syndrome are:

  • Muscle weakness, which usually starts in the legs, but later affects the arms, diaphragm and also the muscles of the face and mouth, impairing speech and eating;
  • Tingling and loss of sensation in legs and arms;
  • Pain in legs, hips and back;
  • Chest palpitations, racing heart;
  • Changes in pressure, there may be high or low pressure;
  • Difficulty breathing and swallowing, due to paralysis of the respiratory and digestive muscles;
  • Difficulty controlling urine and feces;
  • Fear, anxiety, fainting and vertigo.

When the diaphragm is hit, the person may begin to experience difficulty breathing, and in this case it is recommended that the person be connected to devices that help breathing, as the respiratory muscles do not work properly, which can result in asphyxia.

What causes Guillain-Barré syndrome

Guillain-Barré syndrome is an autoimmune disease that occurs mainly due to infection, often a consequence of Zika virus infection. This virus can compromise the functioning of the immune system and the nervous system, resulting in the appearance of the characteristic signs and symptoms of the disease.

Due to changes in the immune system, the organism attacks the peripheral nervous system itself, destroying the myelin sheath, which is the membrane that covers the nerves and accelerates the conduction of the nerve impulse, causing the symptoms.

When the myelin sheath is lost, the nerves become inflamed and this prevents the nerve signal from being transmitted to the muscles, leading to muscle weakness and a tingling sensation in the legs and arms, for example.

Can COVID-19 vaccine cause the syndrome?

According to documents published by the FDA in the United States [1], the vaccine produced by Johnson &Johnson's Janssen laboratory appears to increase the risk of developing Down syndrome. Guillain-Barré in the first 42 days after vaccination. However, this complication remains very rare and is not considered a contraindication for vaccination.

The increased risk of developing Guilin-Barré does not happen with other vaccines such as Moderna or Pfizer. Learn more about COVID-19 vaccines.

How to confirm the diagnosis

Diagnosis of Guillain-Barré syndrome in the early stages is difficult, as the symptoms are similar to many other diseases in which there is neurological impairment.

Thus, the diagnosis must be confirmed by analyzing the symptoms, complete physical examination and performing tests such as lumbar puncture, magnetic resonance imaging and electroneuromyography, which is an examination performed with the objective of evaluating the conduction of the nerve impulse. Learn how the electroneuromyography exam is performed.

All patients diagnosed with Guillain-Barré syndrome must remain hospitalized to be properly monitored and treated, because when this disease is not treated, it can lead to death due to paralysis of the muscles.

How the treatment is done

Treatment for Guillain-Barré Syndrome is aimed at relieving symptoms and accelerating recovery. Initial treatment should be done in the hospital and continued after discharge with physiotherapy sessions.

Usually, hospital treatment is done with:

1. Therapeutic plasmapheresis

Plasmapheresis is a type of treatment that consists of filtering the blood in order to remove excess substances that may be causing the disease. In the case of Guillain-Barré Syndrome, plasmapheresis is performed in order to remove excess antibodies that are acting against the peripheral nervous system and causing the symptoms of the disease.

The filtered blood is then returned to the body, which is stimulated to produce he althy antibodies, thus alleviating the symptoms of the disease. Understand better how plasmapheresis is performed.

2. Immunoglobulin injection

Immunoglobulin treatment consists of injecting he althy antibodies directly into the vein that work against the antibodies that are causing the disease. In this way, treatment with immunoglobulin becomes effective because it promotes the destruction of antibodies that are attacking the nervous system, relieving symptoms.

Physiotherapy treatment

Physiotherapy is important in Guillain-Barré syndrome because it promotes the recovery of muscle and respiratory functions, improving quality of life. It is important that physical therapy be continued for 1 year or more after discharge, until maximum capacity is recovered.

The monitoring of a physical therapist with daily exercises performed with the patient is necessary to stimulate joint movement, improve range of motion, maintain muscle strength and prevent respiratory and circulatory complications. Since, for most patients, the main objective is to walk alone again.

Signs of improvement and worsening

Signs of improvement in Guillain-Barré Syndrome begin to appear about 3 weeks after starting treatment, however most patients only regain control of their movements after 6 months.

The signs of worsening happen when treatment is not started and can take up to 2 weeks to appear after the first symptoms appear. They include difficulty breathing, sudden changes in blood pressure and incontinence, for example.

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