Tuesday, 27 May 2014

What is Guillain-Barré syndrome?

MORE a reaction than a disease, Guillain-Barré syndrome (GBS) is not entirely uncommon. It is seasonal, more frequently seen in men and is usually triggered by respiratory or gastroenterological infection.

Early detection and treatment is key, given one of the more damaging and debilitating ailments that can come with GBS is ascending paralysis.

Basically, you can start to lose the ability to move your toes – and it spreads upwards in a symmetrical fashion.

Hawthorn coach Alastair Clarkson steps aside after GBS diagnosis

A third of patients diagnosed are hospitalised after it is detected through nerve conduction studies, and often, a lumbar puncture.

And, once the syndrome is identified – which can be immediate when symptoms are present – treatment can be administered to halt and reverse the spread of paralysis.

So, what is it? It is an inflammation of the nerve that usually occurs in the arms and legs but can also appear in the chest and face.

Infections such as gut problems, coughs, colds, sore throats, runny noses and flu-type illnesses provoke the response in the body that causes the inflammation.

Basically, the body's immune system attacks its own nerves, which causes damage and can affect muscle movement.

Around 50 per cent of sufferers pick it up after the body has been affected by food poisoning or gastroenterological illnesses.

"It's not really a disease; it's a reaction of the body to some other illness," neurologist and sports physician Dr Paul McCrory told AFL.com.au.

"It's like your nervous system is overly sensitive.

"That's why we see it after infections and things like that; your body develops antibodies, which then affect the nerves."

Symptoms include back pain – like Hawthorn coach Alastair Clarkson suffered – pain in the large leg muscles, sometimes stomach pain, and tingles and weakness in the extremities.

While not every patient suffers paralysis, intravenous treatment can make a quick difference if the disorder is caught early.

But given its lack of awareness, patients can sometimes be slow to report symptoms.

"The public understanding of GBS is not very good. They don't actually know what it is," Professor Fary Khan, the head of rehabilitation at the Royal Melbourne Hospital, said.

"There's no education out there like there is for stroke to recognise symptoms and I think that's because it's not as common.

"It's a bit tricky to say whether everybody will have paralysis.

"It's seasonal – we see it in spasms or seasons. In Melbourne, we usually see it more towards July/August, to November.

"That's when people have bugs although there are cases that are not infective. There is a strong infective component and they often have a history of a bug here or there."

Professor Khan oversees the rehabilitation of the more severely affected GBS patients in the world's only specialised department of its kind.

Quite often, she witnesses the recovery of patients with four paralysed limbs as well as their trunk.

Paralysis can be reversed with treatment but it moves at the painstaking rate of one millimetre a day.

She said the recovery for those seriously disabled by the syndrome could be long and arduous, and patients could also suffer from the psychological fear of a repeat diagnosis.

"It can be pretty horrible," he said.

"Rehabilitation can be the most challenging part of their recovery."

Dr McCrory said GBS wasn't a totally rare complaint with Hawthorn list manager Graham Wright spending a month in hospital with it in 1993 when he was a Collingwood player. 

"It's not an unusual thing, it's very common," he said.

"Everybody's different but if your legs are weak enough they need treatment, we put them on some immunoglobulin, IV treatment, and then over a couple of weeks of physio, they usually get back to their normal self again."

Wright suffered limited paralysis and lost 11kg but played in round one the following season.

POST ORIGINATED FROM http://www.afl.com.au


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