Published on Dec 06, 2013 and last reviewed on Feb 01, 2020 - 1 min read
Abstract
Guillain-Barre syndrome is a rare disorder where the immune system attacks the peripheral nerve cells, resulting in numbness, tingling, and paralysis. This article tells how physiotherapy helps to regain muscle vitality and strength in such patients.
Guillain Barre Syndrome, though a very rare disease has serious manifestations and occurs mostly during adulthood rather than childhood. Guillain Barre syndrome is a manifestation of a virus affecting the nerves and is a peripheral nerve disorder. Its symptoms are diagnosed by a sudden weakness in the limbs where the virus may have attacked and gradually covering other peripheral areas if not started medications immediately. The patient has to confine to a hospital as soon as the symptoms appear.
Symptoms of the disease include:
The prognosis of the disease starts around from the 4th week. With other medications to support the severity of the virus affecting the body, it is also essential to improve muscle wasting, build up chest muscles, and help patient recover physically.
Physical therapy plays an important role to help recover from the physical manifestations of this disease. Physiotherapy can be started after 4 weeks of its prognosis. Patients can be continued full ROM everyday to prevent joint contractures and muscle shortening. With the help of muscle strengthening exercises the lost vitality of the muscles can be brought back.
Isometric and Isokinetic exercises activate muscle strengthening and help to regain posture and build up chest muscles to avoid breathing muscles to collapse. Physiotherapy also teaches mobility, bed transfers and ambulation with minimal help. Gradual gait training (training a patient how to walk safely) is taught with the help of crutches and other walking aids to enable the patient to walk independently.
Physiotherapy also revises the need of orthotic management. An overall functional recovery is initiated with the help of physiotherapy.
The exact cause of Guillain-Barre syndrome is not known. The commonest variant is acute inflammatory demyelinating polyneuropathy (AIDP). About two-thirds of those with AIDP have a prior history of infection and an autoimmune response triggered by the preceding infection, which causes demyelination. This disorder occurs after the occurence of respiratory tract infections and digestive tract infections. It is said that vaccinations and recent surgery can trigger Guillain-Barre syndrome.
People with Guillain-Barre syndrome recover fully, but sometimes it takes a longer time to get out of this problem. One in five people experience long-term effects, some people experience symptoms again after years, and some have permanent nerve damage.
Guillain-Barre syndrome is a heterogeneous group of immune-mediated conditions which affect the nerve and myelin sheath. Distal paraesthesia, facial and bulbar weakness commonly develop, and respiratory weakness requiring ventilatory support occurs in 20% of cases.
Guillain-Barre syndrome occurs at any age but are frequently seen in adults and elderly people. The incidence of Guillain-Barre syndrome is 1-2/100000/year. It occurs in both sexes and are more found in patients with neurological disease.
The pain precedes muscle weakness that ascends rapidly from lower to upper limbs and is more marked proximally than distally in distal paraesthesia. People experience severe nerve pain, urine retention, improper bowel function, and bladder problems during Guillain-Barre syndrome.
Regular monitoring of respiratory function is needed in the acute phase, as respiratory failure may develop with little warning. Active treatment with plasma exchange or intravenous (IV) immunoglobulin therapy shortens the duration of ventilation and improves the prognosis.
Guillain-Barre syndrome is difficult to diagnose at the early stages as it does show any symptoms and cannot be identified at the earliest. The lumbar puncture or spinal tap, electromyography (nerve function test), nerve conduction tests helps to diagnose Guillain-Barre syndrome.
Guillain-Barre syndrome affects the brain by damaging the myelin sheath. Myelin sheath is the layer that protects the nerves. Damage in the nerves prevents the transmission of signals to the brain resulting in paresthesia, mainly distal paresthesia, weakness, and numbness in the brain.
Patients experience numbness, weakness, fatigue, and it takes six months for the people to walk after Guillain Barre syndrome. Overall, 80% of the people recover completely within three to six months, 4% of the people die, and the remainder suffers a residual neurological disability which can be adverse.
During the early stages, it is difficult to identify the condition. After we identify with signs and symptoms, the condition starts to worsen. Within four weeks, it reaches the stage where there is no further change or development. The condition lasts for a year and in some people for three years, after which recovery occurs.
Last reviewed at:
01 Feb 2020 - 1 min read
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