GUILLAIN BARRE SYNDROME

  • This is a paralytic disease seen generally after an infection( generally post-viral infection)
  • Most times involving the Motor system( Movement )
  • This is also called ‘Ascending paralysis’ as the paralysis ascends from feet upwards over the days.
  • Most symptoms start a week after a viral infection. Generally, a diarrhoea bug or throat infection though occasionally after vaccines( as live virus may be used in certain vaccines)
  • Post-infection the body produces various antibodies that may react and destroy the protective lining of nerves.
  • Hence nerves are affected

 

SYMPTOMS

  • In new-born, it’s rare. But they may present with weakness and decreased sucking
  • The weakness generally starts in lower legs and ascends upwards. Slowly involving the upper; legs, waist, chest and the brain. The spread can happen over few days.
  • The symptoms depend on the area paralysed, If the legs are paralysed then the child may not be willing to walk. Late in the disease certain parts of the brain may be involved and the child may have breathing difficulties, swallowing problems.
  • The other parts of the brain controlling the blood pressure, heart rate may be involved.

 

INVESTIGATIONS

  • Lumbar puncture( see segment) is the removal of fluid from the back . This fluid constantly runs around the brain.
  • The conduction of the affected nerve is investigated( Nerve conduction studies)

 

TREATMENT

  • The child needs admission to hospital. The main concerns are paralysis of breathing muscles and paralysis of parts of the brain.
  • Specific antibodies( Immunoglobulin ) is given for 3 to 5 days depending on the condition and response.
  • If breathing deteriorates, then breathing support( Mechanical ventilation) is used
  • Occasionally a steroid may be used to reduce inflammation or the plasma( part of blood containing the bad antibodies) may be exchanged for fresh plasma

 

OUTCOME

  • Most children improve over the next few weeks( 2 to 4 weeks). Some may have a residual weakness.
  • The outcome depends on the severity of infection, the involvement of brain nerves.

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