GBS

What is GBS?

Guillain-Barré Syndrome (GBS) is a rare disorder of the nerves in which patients suddenly develop symptoms of muscle weakness and sensory disturbances that progress rapidly within a day to weeks. Two-thirds of patients have symptoms of an  infection in the weeks prior to the onset of GBS, usually a respiratory tract- or bowel infection (diarrhoea).

Because GBS is a rare disease, few people know its symptoms. The disease often has a major impact on both patients and their families.

Cause

Although the exact cause of GBS is unknown, it is thought to be caused by an aberrant immune response after a preceding infection.

In GBS, this affects the peripheral nervous system: the nerves that provide the connections between the spinal cord and the muscles in the arms, legs and trunk. GBS can cause these muscles to stop functioning properly and become, (temporarily) paralyzed. Damage to the sensory nerves often causes patients to have pain and less feeling in their hands, arms, feet and legs.

Admission

Admission to hospital is (almost) always necessary for GBS because all patients can deteriorate further in the first weeks after the onset of muscle weakness, even if they have little loss of function.

Treatment is absolutely necessary when patients are so severely affected by the disease that they are no longer able to walk ten meters independently or have other serious loss of function.

If the breathing- and swallowing muscles are also affected, people with GBS must be admitted to the Intensive Care Unit (ICU) and may require temporary breathing support by artificial ventilation.  The latter happens in about a quarter of GBS patients.

Recovery

Recovery from the effects of GBS over time varies. About a third of patients recover completely. Another third has mild residual symptoms but can resume normal life. The other patients suffer from more serious residual symptoms that can sometimes seriously affect their daily life, such as severe fatigue, sensory disturbances or pain.

GBS occurs annually in 1 to 2 per 100,000 people. In the Netherlands, about 200 people get the disease every year. GBS is not hereditary and not contagious. The disease can occur at any age, including children and previously healthy people.

Treatment

GBS requires good nursing care with adequate control (monitoring) so that further deterioration of the patient is noticed in time.

The currently available effective treatments for severe forms of GBS are plasma exchange and the administration of an infusion of immunoglobulins (antibodies  from donor blood that inhibit the immune response of patients immune system against the peripheral nerves).

Despite these treatments, about a quarter of the patients continue to deteriorate during or shortly after treatment. New treatment options are therefore urgently required.

Support

To ensure the best possible recovery from GBS, it is important that a rehabilitation doctor is contacted to initiate supportive treatments for the patient.

These treatments include, for example, physiotherapy, occupational therapy, pain treatment, speech therapy and psychological guidance or – in children – pedagogical guidance.