Guillain- Barré Syndrome (GBS), less-known but not uncommon, is a paralytic condition that succeeds pathogenic infections, including innocuous common cold, making preventive healthcare in the ongoing viral season important.
Causes of the syndrome still remain unknown 150 years after it was first described, but underlying mechanism is understood; the body’s immune system inadvertently and suddenly attacks peripheral nerves, rendering limbs paralysed in an ascending fashion.
GBS has attracted attention in the recent past due to its suspected link with the Zika virus, but doctors in the city say they have been witnessing and treating GBS for long.
“Earlier, it was thought that it is an autoimmune disorder, but as we often see, it follows infections. We do get significant number of GBS patients,” informed Dr. J.V. Reddy, Superintendent of state-run Gandhi Hospital, adding that in many cases recovery can take months.
GBS can occur even after an infection (bacterial or viral) has cleared. In the city, GBS has been described following dengue infections in the past.
“It is not uncommon as is believed, but is simply not well-known. However, it can also be mistaken for something else by clinicians,” said Dr. Alok Ranjan, senior neurologist at Apollo Hospitals. “Weakness and accompanying paralysis sets in starting from lower extremities and progressing to the chest, affecting breathing muscles in some cases.”
The progress of paralysis from lower extremities to hands and subsequently chest may be self-limiting at any stage. Treatment is supportive, including physiotherapy, and in cases where respiratory muscles are affected, ventilator support is provided.
While there are no widely-accepted numbers for the city or the State on what the rate of GBS incidence is, a recently published small-sample study estimated the incidence between 1.1 and 1.8 per 100,000 people a year in the city. The study was conducted at a tertiary care centre in Hyderabad. The study was recently published by Dr. S. Sreevani and others in the Indian Journal of Applied Research.
The study also pointed out that GBS incidence is more common in males and affected age-group was 21 to 40 years. Over 40 per cent of the 70 patients diagnosed with GBS at the centre had preceding infection. Importantly, the study showed that more than 85 per cent patients fully recovered within a year.
Dr. Ranjan added that misdiagnosis often results in delay of treatment and loss of time. “A simple EMG test can diagnose the condition. However, a misdiagnosis happens when a doctors suspects spinal cord or brain problem. Physicians should watch out for paralysis where sensitivity in the extremities exists, which is a classical sign of the syndrome.”
