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Guillain-Barre syndrome - Treatment

Alternative Names

Landry-Guillain-Barre syndrome; Acute idiopathic polyneuritis; Infectious polyneuritis; Acute inflammatory polyneuropathy; Acute inflammatory demyelinating polyneuropathy

Treatment:

There is no cure for Guillain-Barre syndrome. However, many treatments are available to help reduce symptoms, treat complications, and speed up recovery.

When symptoms are severe, the patient will need to go to the hospital for treatment, which may include artificial breathing support.

In the early stages of the illness, treatments that remove or block the proteins that attack the nerve cells, called antibodies, may reduce the severity and duration of Guillain-Barre symptoms.

One method is called plasmapheresis, and it is used to remove the antibodies from the blood. The process involves taking blood from the body, usually from the arm, pumping it into a machine that removes the antibodies, and then sending it back into the body.

A second method is to block the antibodies using high-dose immunoglobulin therapy (IVIG). In this case, the immunoglobulins are added to the blood in large quantities, blocking the antibodies that cause inflammation.

Other treatments are directed at preventing complications.

  • Blood thinners may be used to prevent blood clots.
  • If the diaphragm is weak, breathing support or even a breathing tube and ventilator may be needed.
  • Pain is treated with anti-inflammatory medicines and narcotics, if needed.
  • Proper body positioning or a feeding tube may be used to prevent choking during feeding if the muscles used for swallowing are weak.

Support Groups:

Guillain-Barre Syndrome Foundation International - www.gbs-cidp.org

Expectations (prognosis):

Recovery can take weeks, months, or years. Most people survive and recover completely. According to the National Institute of Neurological Disorders and Stroke, about 30% of patients still have some weakness after 3 years. Mild weakness may persist for some people.

A patient's outcome is most likely to be very good when the symptoms go away within 3 weeks after they first started.

Complications:

  • Breathing difficulty (respiratory failure)
  • Contractures of joints or other deformity
  • Deep vein thrombosis (blood clots that form when someone is inactive or confined to bed)
  • Increased risk of infections
  • Low or unstable blood pressure
  • Paralysis that is permanent
  • Pneumonia
  • Skin damage (ulcers)
  • Sucking food or fluids into the lungs (aspiration)

Calling your health care provider:

Seek immediate medical help if you have any of the following symptoms:

  • Can't take a deep breath
  • Decreased feeling (sensation)
    • Difficulty breathing
    • Difficulty swallowing
    • Fainting
    • Loss of movement
  • Reviewed last on: 6/15/2010
  • David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Hughes RA, Raphael JC, Swan AV, van Doorn PA. Intravenous immunoglobulin for Guillain-Barre syndrome. Cochrane Database Syst Rev. 2009;(1):CD002063.

Hughes RA, Wijdicks EF, Barohn R, et al. Practice parameter: immunotherapy for Guillain-Barre syndrome: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2003;61(6):736-740.

Shy ME. Peripheral neuropathies. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 446.

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