Guillain-Barré Syndrome (GBS) is a disorder that affects the peripheral nervous system. The immune system attacks the body’s peripheral nervous system (PNS). The PNS connects the spinal cord and the brain. It is difficult to send signals all over the body if the PNS is damaged.
Quick Facts
- The first symptom is body weakness and a tingling sensation in the legs. This feeling can spread all over your body.
- This is a life-threatening condition. For example, the patient might be having difficulty in breathing.
- In severe cases, patients experience an almost paralyzed state.
- Factors that may trigger Guillain-Barré syndrome are:
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- Recent surgery
- Vaccination
- Weeks after digestive or respiratory tract infection
- Zika virus infection
- COVID-19 virus infection
- Most common in men who are 50 years old
Signs and Symptoms
- Prickling sensations: Usually felt in the wrists, fingers, toes, and ankles
- Weakness: May start on the legs and spreads to the upper part of the body
- Loss of muscle control: This loss of muscle control is felt in the lower part of the body. There is unsteadiness when walking or an inability to walk up and down the stairs
- Difficulty in using the facial muscles: difficulty in swallowing, speaking, or chewing
- Double vision
- Pain: the patient may feel severe pain that worsens at night. Characteristics of pain may be achy, shooting, or cramp-like
- Bladder and bowel control may be difficult
- Fast heart rate
- Blood pressure could be high or low
- Breathing is difficult: this is life-threatening
Patients with Guillain-Barré syndrome may experience sudden weakness. This occurs two weeks after the onset of the first symptom.
The Main Types of Guillain-Barré Syndrome:
- Acute inflammatory demyelinating polyradiculoneuropathy (AIDP): this is most common in areas such as Europe or North America. Symptoms may start as a weakness in the lower part of the body. This symptom may spread to the upper part of the body.
- Miller Fisher syndrome (MFS): this is common in Asia. The symptom may start as paralysis of the eyes.
- Acute motor axonal neuropathy (AMAN) and acute motor-sensory axonal neuropathy (AMSAN): This type is most frequent in Japan, China, and Mexico.
Risk Factors
- Infections caused by bacteria called Campylobacter: a bacteria found in uncooked poultry meat
- Cytomegalovirus
- Influenza virus
- Epstein Barr virus
- Hepatitis A, B, C, and E
- HIV
- Mycoplasma Pneumonia
- Trauma
- Surgery
- Hodgkin’s lymphoma
- Childhood vaccinations: very rare cases
- COVID-19 vaccine
Complications
- Residual numbness
- Heart and blood pressure problems
- Breathing difficulties
- Pain
- Bowel and bladder function problems
- Blood clots
- Pressure sores
- Relapse
It is important for the patient to notify their doctor of the following experiences:
- Tingling or weakness that spreads
- Breathing is difficult for the patient
- Choked by own saliva
- Tingling sensations that start in the patient’s toes or feet that and move up the body
Diagnosis
Cerebrospinal Fluid Analysis can help with the diagnosis of Guillain-Barré syndrome. The doctor will take the spinal fluid sample from the patient using a spinal tap procedure. The patient may feel a little pressure on the back while the patient is in a side-lying position.
It is advised that the patient remains in the side-lying position. Two hours of staying in a side-lying position can help prevent headaches after the procedure.
Treatment
- Acute care
- Plasma exchange (plasmapheresis)
- High dose immunoglobulin therapy: These therapies are only effective within two weeks after the onset of GBS syndrome. Yet, studies have shown that there is no proven benefit of this therapy
- Corticosteroids
- Supportive care
- Rehabilitative care
Nursing Interventions
- Check for changes in the breathing pattern such as the frequency, symmetry, and depth of breathing. Look for changes in skin color, capillary refill, and skin temperature.
- Look for respiratory fatigue signs, characterized by shortness of breath, impaired cough, and decreased attention span.
- Listen to lung sounds for any changes and notify the physician immediately.
- Track oxygen saturation of the patient. This test is used to check the patient’s oxygen level in the body.
- Adjust the bed between 35 degrees to 45 degrees to increase the expansion of the lungs. This will assist the patient with proper breathing.
- Educate the patient about the benefits of chest physiotherapy. This includes deep breathing exercises and chest percussion among others. Perform as advised.
- Suction secretions.
- Check laboratory values such as serum albumin and total protein counts.
- Educate the patient about the importance of maintaining a healthy diet.
