Guillain-Barre syndrome

Guillain-Barré syndrome: A disorder characterized by progressive symmetrical paralysis and loss of reflexes, usually beginning in the legs. The paralysis characteristically involves more than one limb (most commonly the legs), is progressive, and is usually proceeds from the end of an extremity toward the torso. Areflexia (loss of reflexes) or hyporeflexia (diminution of reflexes) may occur in the legs and arms.

Guillain-Barre syndrome is not associated with fever, an important fact in differentiating Guillain-Barre from other diseases. Guillain-Barre usually occurs after a respiratory infection, and it is apparently caused by a misdirected immune response that results in the direct destruction of the myelin sheath surrounding the peripheral nerves or of the axon of the nerve itself. The syndrome sometimes follows other triggering events, including vaccinations. Among the vaccines reportedly associated with Guillain-Barre syndrome are the 1976-1977 swine flu vaccine, oral poliovirus vaccine, and tetanus toxoid. Aside from vaccinations, infection with the bacteria Campylobacter jejuni and viral infections can trigger Guillain-Barre syndrome.

There is presently no test to prove the diagnosis of Guillain-Barre syndrome. Other conditions such as polio that may mimic Guillain-Barre need to be ruled out before the diagnosis is made. Treatment includes plasmapheresis and intravenous gamma globulin (IVIG). In most cases of Guillain-Barre syndrome, the patient makes a complete or nearly complete recovery.

President Franklin D. Roosevelt may not have had polio but rather the Guillain-Barre syndrome, according to a review of his clinical findings in 2003. FDR was diagnosed with polio at age 39 in 1921. As with most distant diagnoses, this is retrospective speculation.

See also: Demyelination; Landry ascending paralysis; Polio.

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