Guillain-Barré syndrome is a rare paralysis disease derived from the fact that the immune system of the body attacks the body’s nerves. The disease starts as a rule with muscle weakness and a tingling and stinging sensation that starts in the legs, and can progress as far as total paralysis of the body’s muscles including the respiratory muscles. In the syndrome the immune system of the body attacks the peripheral nervous system. As a result the envelope of the nerves that serves as an isolating material which enables the conduction of the flow of the electricity along the nerve is damaged. Without this envelope the signals of the nervous system fade and do not reach their destination – the muscles.
The disease could be a serious disease and even life threatening. An attack on the nervous system and following it weakness and paralysis of the muscles of the body could occur very quickly and therefore one must turn to immediate medical treatment in the first stages of the disease. The first symptoms are tingling in the feet that progress towards the thighs and the upper part of the body, muscle weakness that spreads rapidly, difficulties with breathing when in a prone position, unstable gait and difficulty climbing stairs.
The cause of the disease is not completely clear however it has been found that it starts for the most part several days or weeks after various infections: infection by the campylobacter bacteria which attacks the digestive system, viruses attacking the stomach, mononucleosis, flu, tuberculosis, HIV, and sometimes also after Hodgkin’s lymphoma.
Life support treatment
Treatment for the disease is mainly life support treatment that incorporates all the body systems and some 30% of patients will require temporary ventilation. Balance and monitoring is required of blood pressures and pulses due to a concern of harm to the regularity of the heart activity. Some 50% suffer from acute nerve pain which necessitates medication. Many patients experience difficulties with digestion and urine retention. Furthermore due to being in a prolonged prone position there is a risk of patients developing bed sores and thromboses until they start walking again.
Apart from the support treatment – treatments are also provided in hospitals to weaken the immune system in an attempt to stop the progression of the disease. Customary treatments include treatment with high dosage steroids to suppress the immune system, treatment with immunoglobulin (IVIG) which contains “healthy” antibodies which do not attack the body and treatment to replace plasma which contains antibodies that are harmful to the damaged body.
The duration of the acute hospitalization on average per patient is between several weeks to several months, however thereafter some 20% of those suffering from the syndrome remain with physical problems. The most common side effects are muscle weakness and inability to be mobile without the use of a wheelchair, coping with nerve pain (burning, stinging pain,paresthesia, tingling, electric currents), problems with balance, incontinence and more.
Customized rehabilitation treatment
For these patients, who have remained with physical damage which interferes with their daily functioning, they are entitled to and it is recommended that they continue rehabilitation treatment. The treatment is customized for them personally according to the type of injuries remaining, the patient’s wishes and preferences, and assessment by the therapist in Rehabilitation. The treating team includes for the most part:
- Medical rehabilitation follow up dealing with treatment and prevention of life threatening causes, problems with the digestive system and urination, balancing the pain and overall assessment of the patient and his treatment.
- Invalid nursing treatment if required for the patient – monitoring medical risk factors, administering of medications, help with transfers and mobility, with showering, personal hygiene, using the toilet and eating.
- Intensive physiotherapy to strengthen the muscles, maintenance of the ranges of movement of the joints and improvement of movement and mobility disorders.
- Occupational therapy to find solutions and modification of functional auxiliary accessories for daily problems with existing disabilities. Furthermore treatments that can help with sensory regulation and return to normal motor functioning including fine motor functions.
- Rehabilitation psychological support for help with coping during times of crisis.
- Social work support for emotional support and ensuring that the patient receives all his welfare rights.
- Sometimes the services of other types of treatments are used such as psychiatric help, a speech therapist for treating swallowing and speech problems, music therapy, therapeutic occupation, support groups and more.
The information presented in this article is general. It does not constitute medical advice or replace consultation with a physician. It should not be regarded as a recommendation or an alternative for medical treatment.
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