Guillain Barre Syndrome Rare Immune Mediated Polyneuropathy Biology Essay

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Guillain Barre Syndrome (GBS) is a rare immune mediated polyneuropathy that occurs in previously healthy individuals. The purpose of this paper is to provide readers with an understanding of Guillain Barre and conflictions GBS has with other medical resources and diseases. Included in this research paper are topics on origin, symptoms, treatments, medications and conflictions of medical resources with Guillain Barre.

Guillain-Barre syndrome is an acute autoimmune disease that alters the peripheral nervous system and less commonly the motor or cranial nerves. GBS is randomly acquired and is an inflammatory condition that can lead to progressive muscle weakness and paralysis. It is a rare sight in emergency departments, differentiating its early stages from common viral illnesses is also extremely difficult. Inflammation of the peripheral nerves affects the arms and legs resulting in reduced function, weakness, loss of sensation and limb paralysis with or without pain. "Guillain-Barre´ syndrome (GBS) is an immune-mediated polyneuropathy with a worldwide incidence of 1-4 patients per 100 000 inhabitants" (European Journal of Neurology 2008, p. 1332).

Disease Name and Synonyms

"The syndrome was named after the French physicians Guillain, Barre and Strohl, who were the first to describe it in 1916. It is sometimes called Landry's paralysis, after the French physician who first described a variant of it in 1859." (All about Guillain Barre Syndrome. (01-2009) symptoms. Retrieved from http://www.jsmarcussen.com/gbs/uk/symptoms.htm)

GBS is not just one disease the syndrome has several variations differentiated by their symptoms, the infections preceding it, the extent of the inflammatory phase, severity, and disorder site.

Common variations of the disorder are as follows: Acute Inflammatory Demyelinating Polyneuropathy (AIDP) which is the most frequent form of GBS in the Western part of the World. Acute Motor Axonal Neuropathy (AMAN), Acute Motor and Sensory Axonal Neuropathy (AMSAN) and the cranial nerve variant of GBS called Miller Fisher Syndrome (MFS).

Symptoms

Symptoms generally begin in the patient's feet, hands or face, spread to the legs or arms, and increase in intensity as symptoms move towards the center of the body. They generally appear on both left and right sides of the body. GBS is so unpredictable that motor symptoms or disruptions in the autonomous system have been observed. 'It has been reported in rarer cases that GBS has affected an arm or leg without spreading to the rest of the individual's body. '(All about Guillain Barre Syndrome. (01-2009) symptoms. Retrieved from http://www.jsmarcussen.com/gbs/uk/symptoms.htm)

In some patients, the skin develops hyperalgesia, or tenderness to touch intensified by bed sheets, socks and tight-fitting shoes; in some cases pain may limit walking. Patients with symptoms limited to the feet and ankles may observe similar symptoms in the fingertips; as the symptoms extend to the knees they may also extend to the wrists. Only rarely do these symptoms extend above the knees.

The patient loses the ability to tell the difference between hot and cold, and may feel cold or may sweat for no apparent reason. He or she may even get hurt without noticing. The patient's sense of taste can be affected too. Motor nerve fibers may be damaged

The patient experiences a communication breakdown between what he wants to do and his ability to do it; because the motor nerves control movement, and damage inflicted to them results in partially or completely blocked signals. The body area affected by the damaged nerves loses its ability to function normally, resulting in reduced movement or coordination. The patient's muscles weaken and atrophy. Tendon reflexes are reduced or lost. An example of this is gently tapping the front of the patient's knee and that act not inducing a (kick) reaction.

Progressive weakening or paralysis may occur, typically beginning in the feet, hands or face. The paralysis characteristically involves more than one limb, most commonly the legs. The paralysis is progressive and usually ascending, spreading to the rest of the limb, and from there may spread to the legs, arms and the rest of the body. Legs feel heavy, it gets difficult to stand up or climb stairs, to walk or stand. The patient may have difficulty holding and manipulating objects, such as buttons and toothbrushes. Arms feel weak and the patient can no longer lift heavy objects. The weakness may be accompanied by pain and muscle spasms. Constipation is also often a problem, due to the reduced activity of the intestines, change of diet, weakened stomach muscles that resist efforts by the patient to express the intestinal content.

About 28% of patients with the syndrome remain able to walk unaided.

In some cases, the face may be affected when damage occurs to the cranial nerves. These connect the brain to the muscles of the jaw, face and tongue, and also control the muscles that move the patient's head, neck and shoulders. As the paralysis progresses, all these areas may be paralysed. The eyelids or one side of the face may droop; the face loses its ability to express feelings. The patient's voice may change because the vocal chords are affected. Speech may be unintelligible, because the various muscles required to form speech are weakened. Deafness is unusual but has been reported.

The progressive weakness affects patients with varying intensities, sees below, and may be life-threatening.

Autonomic nerve system may be disrupted

The combination of pain, weakness and sensory disruptions are generally so alarming that the more discreet changes in the patient's autonomous nerve system may be overlooked. These may be just as serious, as detailed below.

The autonomous nerves control the inner organs, whose function is normally carried out automatically, such as secretion of hormones, vision, urination, breathing, heart beat, etc. These functions may be disrupted, resulting in arrhythmia, unstable blood pressure, blurred or double vision, dizziness, fainting spells, inability to regulate the body temperature, difficulty breathing, reduced ability to control the function of the stomach, digestive system and bladder, loss of weight, vomiting after meals, reduced function of various glands, incontinence, impotency, etc. It may be difficult to urinate, and the bladder may feel as it is not being emptied.

http://www.jsmarcussen.com/gbs/uk/symptoms.htm

Conflictions of Medical Resources with Guillain Barre

In 1976, vaccination against a novel swine-origin influenza A (H1N1) virus was associated with a statistically significant increased risk for GBS in the forty two days after vaccination (approximately 10 excess cases per 1 million vaccinations), a consideration in halting the vaccination program in the context of limited influenza virus transmission.

References

Rudolph, T. T., Larsen, J. P., & Farbu, E. E. (2008). The long-term functional status in patients with Guillain-Barré syndrome. European Journal of Neurology, 15(12), 1332-1337.

Prothro, C. C., K., K., Fiellin, M. M., Meek, J. J., Tellman, N. N., Milewski, M. M., & ... Kirschke, D. D. (2010). Preliminary Results: Surveillance for Guillain-Barré Syndrome After Receipt of Influenza A (H1N1) 2009 Monovalent Vaccine -- United States, 2009-2010. MMWR: Morbidity & Mortality Weekly Report, 59(21), 657-661. Retrieved from EBSCOhost.described a variant of it in 1859." (All about Guillain Barre Syndrome. (01-2009) symptoms. Retrieved from http://www.jsmarcussen.com/gbs/uk/symptoms.htm)

GBS is not just one disease the syndrome has several variations differentiated by their symptoms, the infections preceding it, the extent of the inflammatory phase, severity, and disorder site.

Common variations of the disorder are as follows: Acute Inflammatory Demyelinating Polyneuropathy (AIDP) which is the most frequent form of GBS in the Western part of the World. Acute Motor Axonal Neuropathy (AMAN), Acute Motor and Sensory Axonal Neuropathy (AMSAN) and the cranial nerve variant of GBS called Miller Fisher Syndrome (MFS).

Symptoms

Symptoms generally begin in the patient's feet, hands or face, spread to the legs or arms, and increase in intensity as symptoms move towards the center of the body. They generally appear on both left and right sides of the body. GBS is so unpredictable that motor symptoms or disruptions in the autonomous system have been observed. 'It has been reported in rarer cases that GBS has affected an arm or leg without spreading to the rest of the individual's body. '(All about Guillain Barre Syndrome. (01-2009) symptoms. Retrieved from http://www.jsmarcussen.com/gbs/uk/symptoms.htm)

In some patients, the skin develops hyperalgesia, or tenderness to touch intensified by bed sheets, socks and tight-fitting shoes; in some cases pain may limit walking. Patients with symptoms limited to the feet and ankles may observe similar symptoms in the fingertips; as the symptoms extend to the knees they may also extend to the wrists. Only rarely do these symptoms extend above the knees.

The patient loses the ability to tell the difference between hot and cold, and may feel cold or may sweat for no apparent reason. He or she may even get hurt without noticing. The patient's sense of taste can be affected too. Motor nerve fibers may be damaged

The patient experiences a communication breakdown between what he wants to do and his ability to do it; because the motor nerves control movement, and damage inflicted to them results in partially or completely blocked signals. The body area affected by the damaged nerves loses its ability to function normally, resulting in reduced movement or coordination. The patient's muscles weaken and atrophy. Tendon reflexes are reduced or lost. An example of this is gently tapping the front of the patient's knee and that act not inducing a (kick) reaction.

Progressive weakening or paralysis may occur, typically beginning in the feet, hands or face. The paralysis characteristically involves more than one limb, most commonly the legs. The paralysis is progressive and usually ascending, spreading to the rest of the limb, and from there may spread to the legs, arms and the rest of the body. Legs feel heavy, it gets difficult to stand up or climb stairs, to walk or stand. The patient may have difficulty holding and manipulating objects, such as buttons and toothbrushes. Arms feel weak and the patient can no longer lift heavy objects. The weakness may be accompanied by pain and muscle spasms. Constipation is also often a problem, due to the reduced activity of the intestines, change of diet, weakened stomach muscles that resist efforts by the patient to express the intestinal content.

About 28% of patients with the syndrome remain able to walk unaided.

In some cases, the face may be affected when damage occurs to the cranial nerves. These connect the brain to the muscles of the jaw, face and tongue, and also control the muscles that move the patient's head, neck and shoulders. As the paralysis progresses, all these areas may be paralysed. The eyelids or one side of the face may droop; the face loses its ability to express feelings. The patient's voice may change because the vocal chords are affected. Speech may be unintelligible, because the various muscles required to form speech are weakened. Deafness is unusual but has been reported.

The progressive weakness affects patients with varying intensities, sees below, and may be life-threatening.

Autonomic nerve system may be disrupted

The combination of pain, weakness and sensory disruptions are generally so alarming that the more discreet changes in the patient's autonomous nerve system may be overlooked. These may be just as serious, as detailed below.

The autonomous nerves control the inner organs, whose function is normally carried out automatically, such as secretion of hormones, vision, urination, breathing, heart beat, etc. These functions may be disrupted, resulting in arrhythmia, unstable blood pressure, blurred or double vision, dizziness, fainting spells, inability to regulate the body temperature, difficulty breathing, reduced ability to control the function of the stomach, digestive system and bladder, loss of weight, vomiting after meals, reduced function of various glands, incontinence, impotency, etc. It may be difficult to urinate, and the bladder may feel as it is not being emptied.

http://www.jsmarcussen.com/gbs/uk/symptoms.htm

Conflictions of Medical Resources with Guillain Barre

In 1976, vaccination against a novel swine-origin influenza A (H1N1) virus was associated with a statistically significant increased risk for GBS in the forty two days after vaccination (approximately 10 excess cases per 1 million vaccinations), a consideration in halting the vaccination program in the context of limited influenza virus transmission.

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