GUILLAIN-BARRE

SYNDROME

Dhayanee Vengadesan (11616103)

Jerina Khar Yoke Yin (11616102)
Syifa Fauziah (11616105)
 Guillain-Barré Syndrome
• Guillain-Barré syndrome (GBS) is a rare, autoimmune
disorder in which a person’s immune system attacks
the peripheral nerves. (WHO)
• Affecting the peripheral nerves responsible for:
1. Controlling muscle movement
2. Transmitting pain, temperature and touch sensations.

Resulting in muscle weakness and loss of sensation /

paralysis in the legs and/or arms.

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 Guillain-Barré Syndrome
• It is an acute form of polyneuritis:
Chronic Inflammatory
Demyelinating Polyneuropathy
(CIDP).

Demyelination disrupts the

mechanisms of transmembrane
Na+, K+ and Ca2+ ions in the
action potential conduction
throughout the nerve cells

Decreasing efficiency of action

potential conduction and
metabolic crisis

Conduction failure within the

affected axon

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 SYMPTOMS
1. Progressive muscle weakness or paralysis in the legs and arms
2. A tingling in the fingers and toes or numbness
3. A sudden “giving way” in the legs
4. Difficulty walking
5. Balance problems (unsteadiness)
6. Trouble chewing or swallowing
7. Difficulty breathing

LATER SYMPTOMS :
 Paralysis – Leg, arm, face, respiratory muscle
 Slow heart rate
 Low blood pressure
 Severe pain in spine and arms

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 Spinal tap
(Lumbar
puncture)

EMG
Electromyography

NCS
Nerve Conduction
Studies

DIAGNOSIS 5
 CHARACTERIZATION
Lumbar puncture for cerebrospinal fluid
(CSF): albuminocytologic dissociation,
elevation in CSF protein (>0.55 g/L) without
an elevation in white blood cellls.

Electromyography (EMG) and nerve

conduction studies (NCS) can be very
helpful in the diagnosis. Abnormalities in
NCS that are consistent with demyelination
are sensitive and represent specific
findings for classic GBS.
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 PREVALENCE & INCIDENCE
PREVALENCE INCIDENCE
• GBS affects between 1 to 4
per 100,000 of the world’s • Average annual age-specific incidence in
population annually GBS, United States (1985-1991)
• Older adults of at least 50
years of age are at greatest
risk
• More common in men than in
women

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 Prevalence of Guillian-Barré Syndrome
Throughout The World

Source:
http://www.thelancet.com/journals/laneur/article/PIIS1474-4422(13)70215-1/fulltext

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Source: http://www.rightdiagnosis.com/g/guillain_barre_syndrome/stats-country.htm#extrapwarning

WARNING! EXTRAPOLATION ONLY. NOT BASED ON COUNTRY-

SPECIFIC DATA SOURCES. The following table attempts to
extrapolate the above incidence rate for Guillain-Barre Syndrome to
the populations of various countries and regions.

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 ETIOLOGY
• Exact cause is unknown
• Disorder usually appears days after a
respiratory or digestive tract infection
(Campylobacter jejuni, Zika virus, etc)
• About two-thirds of people with GBS
had diarrhea or a respiratory illness
several weeks before developing
symptoms.
Campylobacter jejuni
• Gram-negative, spiral shaped
bacteria
• Most commonly found in animal
feces
• Infection results in an acute, self-
limited gastrointestinal illness
characterized by diarrhea, fever,
and abdominal cramps.
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 ETIOLOGY
• GIT infection
Campylobacter jejuni
Cytomegalovirus
• Respiratory tract infection
Mycoplasma pneumoniae
• Ebstein-Barr virus Campylobacter

• Vaccines Vaccines jejuni

Rabies
Avian-flu influenza
Cytomegalovirus

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 RISK FACTORS
Several things are known to trigger GBS:
1. Preceded by a bacterial or viral infection
Campylobacter jejuni (diarrhea) -> most common About 1 in every 1,000
reported Campylobacter
Flu illnesses leads to GBS.
40% of GBS cases in
Cytomegalovirus the US are thought to be
Epstein Barr virus triggered by this bacteria

Zika virus
2. Vaccine administration or surgery (e.g. influenza vaccine, orthopedic
surgeries)
3. Age (about 50 years old)
4. Gender (Men more likely than woman)
5. Autoimmune

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 COMPLICATIONS
Approximately 1 or 2 people in every 10 will not recover completely
from Guillain-Barré syndrome

LONG TERM COMPLICATION

 Difficulty in walking – Might need a wheelchair
 Loss of balance
 Severe nerve pain
 Loss of sensation (numbness) which leads to lack of co-ordination.
 Problem with sense of touch (dysesthesia)
 Easily fatigue

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LIFE THREATENING COMPLICATION
1 out of 20 people die from Guillain Barre syndrome.

 Difficulty in breathing – Lungs unable to provide enough oxygen

for the rest of the body
 Sepsis - Body's extreme response to an infection
 Pneumonia – Swelling of tissues in both lungs due to infection of
bacteria, fungi, virus or parasites.
 Cardiac arrest – Irregular heart beat rhythm causes heart to stop.
 Blood Cloths – Immobility could lead to developing blood cloth

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 TREATMENTS
• Currently no cure for Guillain-Barré Syndrome.

Treatments Available

Therapies to boost
High-dose Intravenous
immunoglobulin gamma-globulin
Plasma
exchange
the immune
(IVIG) (IVGG)
system.

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 TREATMENTS
 Plasma exchange (plasmapheresis)
The liquid portion of part of your blood (plasma) is removed and
separated from your blood cells. The blood cells are then put back into
your body, which manufactures more plasma to make up for what was
removed. Plasmapheresis may work by ridding plasma of certain
antibodies that contribute to the immune system's attack on the
peripheral nerves.

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 Immunoglobulin therapy
Immunoglobulin containing healthy antibodies from blood donors
is given through a vein (intravenously). High doses of immunoglobulin can
block the damaging antibodies that may contribute to Guillain-Barre
syndrome.
You also are likely to be given medication to:
Relieve pain, which can be severe
Prevent blood clots, which can develop while you're immobile

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 CARE
• People with Guillain-Barre syndrome need physical
help and therapy before and during recovery. Your care
may include:
• Movement of your arms and legs by caregivers before
recovery, to help keep your muscles flexible and strong
• Physical therapy during recovery to help you cope with
fatigue and regain strength and proper movement
• Training with adaptive devices, such as a wheelchair or
braces, to give you mobility and self-care skills

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THANK
YOU
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