Guillain–Barré-Strohl syndrome, is an acute polyneuropathy, a disorder affecting the peripheral nervous system. Ascending paralysis, weakness beginning in the feet and hands and migrating towards the trunk, is the most typical symptom, and some subtypes cause change in sensation or pain as well as dysfunction of the autonomic nervous system. It can cause life-threatening complications, in particular if the breathing muscles are affected or if there is autonomic nervous system involvement. The disease is usually triggered by an infection. The diagnosis is usually made by nerve conduction studies and with studies of the cerebrospinal fluid. With prompt treatment by intravenous immunoglobulins or plasmapheresis, together with supportive care, the majority will recover completely. Guillain–Barré syndrome is rare, at 1–2 cases per 100,000 people annually, but is the most common cause of acute non-trauma-related paralysis in the world.
Guilian-barre – is a lower motor neuron disease and a sensory neuron disease – because it effects all the nerves of the PNS – also called acute ideopathic polyneuropathy – which means come on quickly and goes away quickly , no idea were it comes from and it effects many neurons – also called landry's ascending paralysis – its called this because the problem usually occur in the legs and the move up the body. There is acute inflamation of the PNS and the motor and sensory nerves are eaten just like in MS and you egt focal demyelination in various areas – you find lymphocytes within the nerves. Believed to be an autoimmune disease but not really sure were it comes from. Often occurs a few weeks after a viral infection or in some cases after surgery. The myelin sheaths are ingested by phagocytes but the schwan cells remain – this causes the loss of a nerve signal because it stop salvatory conduction – In severe cases there are wild fluctuations in blood pressure and breathing issues , this loss of respiration can be the cause of death in many pt's. 3-4% mortality this happens when it get into the cranial nerves though in other cases this just causes sever symptoms such as trouble speaking , swallowing and control of fascial muscles. However most people recover , in most people the pattern is symptoms getting worse for 2-3 weeks and then they plateau for a few weeks and then they get better and in most cases they fully recover and its gone for good. This recovery happens because the nerves regrow. In very sever cases the axon itself can die back – so to recover two things have to happen 1. the axon has to grow back and 2. you have to re-myelinate the nerves.
In early cases of Guilian-barre and especially in MS – the sodium potasium pumps can migrate down into the unmyelinated areas so the signal can get past that area or you get remyelination, either way these symptoms will go away kin a few weeks. However, in 1/3 of people there may be residual symptoms.
- 10% of people get a chronic relapsing/remitting form of
- Guilian-barre. Key to diagnosing Guilian-barre is blood pressure fluctuations, ascending weakness and it occurred after infection.
Treatment – plasmapheresis – is used to speed recovery which is when they filter the immune cells out of the blood, this is done because they think its an autoimmune disease.