Guillain-Barré Syndrome and Multiple Sclerosis – what is the relationship?
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Guillain-Barre syndrome
The Infections That Cause Guillain-Barré Syndrome
Guillain-Barré Syndrome (GBS) is a rare, but serious condition where the person’s immune system mistakenly attacks the peripheral nervous system. Up to half of people experience severe nerve pain and triggers have been linked mainly to infections. GBS is characterised by a rapid-onset change in sensation or pain and muscle weakness, usually starting in the hands and feet, which can lead to paralysis. The reason why the immune system attacks the peripheral nervous system is unclear, but links between certain viruses triggering GBS have been found.
Campylobacter Infection
Campylobacter is the most common cause of food poisoning in the UK and many other developed countries. Since laboratories were able to isolate campylobacter in stool specimens 20 years ago a link between it and GBS became apparent as people reported its onset after infection. More recently, stronger evidence has been able to support the association. Based on a study by McCarthy and Giesecke it’s estimated that 14% of people will develop GBS following a campylobacter infection.
The Link Between Zika Virus And GBS
The link between the Zika virus and GBS was first reported in 2014, and in 2016 the World Health Organisation concluded that it is a trigger. A 2016 study by Cao-Lormeau et al. found that 88% of patients with GBS had a history of viral infection 6 days before the onset. The results were compared against control patients and other infections and the Zika virus showed a stronger correlation as a trigger for GBS. Many countries with the Aedes mosquitoes, which carry the Zika virus, have also reported an unusual increase in GBS, adding to the strength of the theory that the two are linked.
Long-Term Treatment For GBS
Unfortunately, up to 20% of people left severely disabled after having GBS and others have persistent symptoms, such as poor balance, coordination and muscle weakness. Long-term treatment often involves physical therapy to strengthen muscles or re-learn movements, such as walking. An occupational therapist can help find ways to do daily tasks that you’ve always done but now find difficult. The Speech And Language Therapy (SALT) team may also be involved if you have problems with speech or swallowing and can help to strengthen these muscles or find alternatives that suit you, such as puréed foods. Counselling is helpful when GBS is life-changing, which can be overwhelming and difficult to deal with, so having a professional to talk to is beneficial.
To reduce your chance of developing GBS you should take precautions to avoid the infections that can trigger it. When it comes to food poisoning, make sure meat, especially poultry, is stored and cooked correctly to kill off campylobacter. If you’re in a country where Aedes mosquitoes are prominent, be sure to use insect repellent and wear clothes that fully cover your skin. Treatment can be a long battle, but it is possible. Using the affected muscles is the best way to get them working correctly again.
Guillain-Barré Syndrome – why you need to know the signs and symptoms of Guillain-Barré Syndrome
Guillain-Barré Syndrome
Signs and Symptoms
Guillain-Barré Syndrome
Guillain-Barré (pronounced ghee-yan bar-ray) syndrome is a very rare and serious condition that affects the nerves.
It mainly affects the feet, hands and limbs, causing problems such as numbness, weakness and pain.
It can be treated and most people will eventually make a full recovery, although it can occasionally be life-threatening and some people are left with long-term problems.
Guillain-Barré syndrome affects people of all ages, but your chances of getting it increase as you get older.
Symptoms of Guillain-Barré syndrome
Symptoms often start in your feet and hands before spreading to your arms and legs.
At first you may have:
numbness
muscle weakness
pain
problems with balance and co-ordination
These symptoms may continue to get worse over the next few days or weeks before they start to slowly improve. In severe cases, you may have difficulty moving, walking, breathing and/or swallowing.
Read more about the symptoms of Guillain-Barré syndrome.
When to get medical help
See your GP if you notice any of the early symptoms of Guillain-Barré syndrome, such as numbness or weakness.
Call 999 for an ambulance or go to your nearest accident and emergency (A&E) department immediately if someone:
has difficulty breathing, swallowing or speaking
can’t move their limbs or face
faints and doesn’t regain consciousness within two minutes
This is a medical emergency and the person needs to be seen in hospital as soon as possible.
Read more about how Guillain-Barré syndrome is diagnosed.
Causes of Guillain-Barré syndrome
Guillain-Barré syndrome is thought to be caused by a problem with the immune system, the body’s natural defence against illness and infection.
Normally the immune system attacks any germs that get into the body. But in people with Guillain-Barré syndrome, something goes wrong and it mistakenly attacks and damages the nerves.
It’s not clear exactly why this happens, but it can be triggered by:
an infection, such as food poisoning, flu or cytomegalovirus
a vaccination, such as the flu vaccine (but this is extremely rare and the benefits of vaccination outweigh any risk)
surgery, a medical procedure or an injury
Read more about causes of Guillain-Barré syndrome.
Treatments for Guillain-Barré syndrome
Most people with Guillain-Barré syndrome are treated in hospital.
The main treatments are:
intravenous immunoglobulin (IVIG) – a treatment made from donated blood that helps bring your immune system under control
plasma exchange (plasmapheresis) – an alternative to IVIG where a machine is used to filter your blood to remove the harmful substances that are attacking your nerves
treatments to reduce symptoms and support body functions, such as painkillers, a machine to help with breathing and/or a feeding tube
Most people need to stay in hospital for a few weeks to a few months.
Read more about how Guillain-Barré syndrome is treated.
Recovering from Guillain-Barré syndrome
Most people with Guillain-Barré syndrome make a full recovery, but this can take months or even years.
Some people won’t make a full recovery and are left with long-term problems such as:
being unable to walk without assistance
weakness in your arms, legs or face
numbness, pain or a tingling or burning sensation
balance and co-ordination problems
extreme tiredness
Therapies such as physiotherapy, occupational therapy and speech and language therapy can help you recover and cope with any lasting difficulties.
Very occasionally, Guillain-Barré syndrome can cause life-threatening problems such as severe breathing difficulties or blood clots. Overall, around 1 in 20 cases is fatal.
Zika Virus – What is the Zika Virus and should we be alarmed?
Check out this excellent introduction to the Zika Virus from Dr Margaret Chan, Director- General of WHO. Why we all need to be very concerned!
Dr Margaret Chan, Director- General of WHO
“The Zika virus was first isolated in 1947 from a monkey in the Zika forest of Uganda. Its historical home has been in a narrow equatorial belt stretching across Africa and into equatorial Asia.
For decades, the disease, transmitted by the Aedes genus of mosquito, slumbered, affecting mainly monkeys. In humans, Zika occasionally caused a mild disease of low concern.
In 2007, Zika expanded its geographical range to cause the first documented outbreak in the Pacific islands, in the Federated States of Micronesia. From 2013-2014, 4 additional Pacific island nations documented large Zika outbreaks.
In French Polynesia, the Zika outbreak was associated with neurological complications at a time when the virus was co-circulating with dengue. That was a unique feature, but difficult to interpret.
The situation today is dramatically different. Last year, the virus was detected in the Americas, where it is now spreading explosively. As of today, cases have been reported in 23 countries and territories in the region.
The level of alarm is extremely high.
Arrival of the virus in some places has been associated with a steep increase in the birth of babies with abnormally small heads and in cases of Guillain-Barre syndrome.
A causal relationship between Zika virus infection and birth malformations and neurological syndromes has not yet been established, but is strongly suspected.
The possible links, only recently suspected, have rapidly changed the risk profile of Zika, from a mild threat to one of alarming proportions. The increased incidence of microcephaly is particularly alarming, as it places a heart-breaking burden on families and communities.
WHO is deeply concerned about this rapidly evolving situation for 4 main reasons:
• the possible association of infection with birth malformations and neurological syndromes
• the potential for further international spread given the wide geographical distribution of the mosquito vector
• the lack of population immunity in newly affected areas
• and the absence of vaccines, specific treatments, and rapid diagnostic tests.
Moreover, conditions associated with this year’s El Nino weather pattern are expected to increase mosquito populations greatly in many areas.
The level of concern is high, as is the level of uncertainty. Questions abound. We need to get some answers quickly.”