Guillian-Barre syndrome

Abstract

Guillian-Barre syndrome (GBS) is the most common cause of acute flaccid paralysis. All age groups can be affected, more common in elderly. Campylobacter jejuni, a major cause of bacterial gastroenteritis worldwide has become recognized as a most frequent antecedent pathogen for GBS. A prospective case-controlled study showed, positive C. Jejuni serology was found in an unprecedented high frequency of 57% as compared to 8% in family controls and 3% in control patients with other neurological diseases. In GBS there is molecular mimicry between epitops found in the cell walls of some micro-organisms and gangliosides in schwann cell membrane. Diagnosis is mainly clinical. The mainstay of treatment of GBS is supportive care and prevention of complications. Respiratory failure and autonomic dysfunction are the common causes of death from GBS. Plasma exchange and intravenous immunoglobulin therapy shorten the duration of ventilation and improve prognosis. Overall, prognosis of GBS is good. Eighty percent of patients recover completely within 3-6 months, 4% die, and the remainder suffers residual neurological disability. GBS may be prevented by development of a vaccine against C. Jejuni. Early and specific diagnosis is important to ensure a favourable outcome.