Diagnosing Guillain-Barre syndrome
Diagnosing Guillain-Barre syndrome requires a careful medical history, including history of recent infections and medical treatments. Two signs are important in helping the clinician decide if the patient has GBS:
- arms and legs are getting weaker
- loss of reflexes, which are automatic body movements you cannot control
Your doctor may also order tests such as:
- lumbar puncture to examine cerebrospinal fluid for increased protein level without increased cell count
- nerve conduction study to assess how your nerves and muscles respond to small electrical stimuli and electromyography (EMG) to determine if your weakness is caused by muscle damage or nerve damage
Treating Guillain-Barre syndrome
Supportive care is critical to keep the patient alive during the first four weeks of illness. Of greatest concern is respiratory failure due to paralysis of the diaphragm, which is the most important muscle for breathing.
Subsequent treatment involves reducing the body’s attack on the nervous system. There are two types of treatments used to do this:
- Plasmapheresis, also known as plasma exchange, consists of removing the liquid portion of your blood, also known as the plasma, and separating it from the actual blood cells. The blood cells are then put back in your body and your body manufactures more plasma to replace the plasma that was removed. It is believed that plasmapheresis rids the blood of certain antibodies that contribute to the immune system attack on the peripheral nerves.
- Intravenous immunoglobulin, which contains healthy antibodies from blood donors. High doses of immunoglobulin can block the damaging antibodies that may contribute to Guillain-Barre syndrome.
These treatments are equally effective. Mixing the treatments or administering one after the other is no more effective than using either method alone.
Before recovery begins, patients may need to have their arms and legs manually moved by a caregiver to keep muscles flexible and strong. Physical therapy will most likely be needed after recovery has begun to help regain strength and proper movement.