Guillain-Barre Syndrome (GBS) And Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)
Guillain-Barre Syndrome (GBS) And Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)
In patients with Guillain-Barre syndrome (GBS), acute inflammatory reactions occur in the peripheral nerves. An autoimmune attack on the myelin, structure of insulation around nerve fibers, results in loss of myelination (demyelination). Loss of myelin can occur in sensory, motor or autonomic nerve fibers, thus causing a variety of clinical symptoms and body dysfunction. This will result in slow and incomplete recovery.
Another form of this disease may present chronically, with episodic worsening and progressive symptoms and disability. This type of peripheral nerve damage is called CIDP (Chronic inflammatory demyelinating polyneuropathy).
SYMPTOMS:
SYMPTOMS:
Patients with GBS develop rapid, progressive sensory symptoms. These symptoms may include paresthesia and numbness, weakness and cramping in their legs and arms. Weakness may affect breathing, chewing and swallowing. Difficulty breathing may lead to a medical emergency due to respiratory distress or arrest. A number of patients may develop autonomic dysfunction with fluctuations in their blood pressure and cardiac arrhythmias. GBS is one of the true neurological emergencies. Patients may require hospital admission and/or intensive care unit admission during the initial acute phase of the illness. This is in contrast to CIDP, which is a slowly progressive illness with multiple sensory, motor and autonomic symptoms.
INTRODUCTION
INTRODUCTION
TREATMENT:
GBS patients with respiratory failure require full supportive care in the intensive care unit. Plasma exchange or intravenous immunoglobulins (IVIG) is demonstrated to be effective in treating GBS. Patients with CIDP often respond to corticosteroids treatment. Long-term use of corticosteroids is however associated with multiple complications and, switching to “corticosteroid-sparing” agents may minimize the side effects. Acute exacerbations of CIDP symptoms can be treated with intravenous immune globulins (IVIG) or plasma exchange. Other managements include treatment of neuropathic pain due to CIDP with anti-seizure medications, antidepressants or analgesics. For patients with severe painful conditions, referrals to the Chronic Pain Management Clinic may be indicated, and proven to be effective.