Guillain-Barre Syndrome

Syndrome (GBS) is a exceptional medical condition that affects the nerves outer surface the brain and spinal cord. Even though it can be frightening because it often causes people to have some type of paralysis, Guillain-Barre (pronounced: ghee-yan bah-ray) syndrome is very rare: It just affects 1 or 2 people in every 100,000. Most of the people who do get Guillain-Barré syndrome improve and are able to return to their normal lives and activities.

Symptoms

An initial episode of a headache, vomiting, fever and back and limb pain is followed by paralysis, which starts as tingling and numbness followed by increasing weakness. The paralysis is often progressive and ascending (starting with the feet and moving upwards), but the condition may come on suddenly and affect all four limbs at once. The degree of paralysis varies.

There may also be a loss of sensation, sometimes with pain. In about one in four cases the paralysis spreads to the respiratory nerves controlling breathing and the person needs to be put on a ventilator.

Some patients have a similar but longer-lasting illness called chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), once known as chronic Guillain-Barre but now usually regarded as a related condition.

Who's affected?

Guillain-Barre affects about 1,500 people every year in the UK, and about 150 develop CIDP. The exact mechanisms that cause the conditions aren't clear, but about 60 per cent of those affected will have had a throat or intestinal infection, flu or major stress within the previous two weeks. This triggers the immune system, which then attacks the nerves.

It rarely occurs in first-degree relatives, but familial cases have been reported and genetic similarities noted. For example, a study of Japanese people with Guillain-Barre following an intestinal infection with the bacteria Campylobacter jejuni found they were more likely to have a rare version of the gene for an immune system chemical known as tumour necrosis factor.