The Guillain Barré Syndrome


Published in: Today Digital
Author: Dr. Adriano Martínez Reyes, Neurologist, Neurology of the General Hospital of the Plaza de la Salud.

Guillain Barré Syndrome (GBS) is a neurological disease, described by French neurologists, for the first time in 1859 by Jean Baptiste Octave Landry, and in 1916 by Georges Charles Guillain and Jean-Alexandre Barré.

It is a clinical syndrome that as main features highlights the loss or reduction of muscle strength in the muscles of the extremities and muscles that we use to breathe in the most severe cases.

It is a disease that can affect otherwise healthy people, who after a gastrointestinal infection, or a viral condition have a picture that evolves from the mere sensation of numbness or cramps in the legs, paralysis of the muscles of facial expression, to respiratory failure in a period of 2 to 4 weeks. It is common that in addition to these symptoms dominate pain in the lower back, urinary retention, constipation, difficulty digesting food or water; Less common symptoms include atypical or infrequent presentations with involvement of the nerves involved in the movement of the eyes, isolated weakness only in the arms and hands.

The frequency of the disease is 0.5 to 2 cases per one hundred thousand inhabitants per year, that is, in a population of ten million people it is expected that between fifty and two hundred cases per year will be diagnosed.

It is estimated that one out of every thousand people will suffer from the disease during some time of their life.

Since its description in 1859 there have been periods of surprising increase in the frequency of cases, as in 1979 during the period of vaccination against influenza A / H1N1 where the incidence of GBS increased 9.5 times. In our country due to the arrival of the Zika virus, there was a notable increase in the cases of Guillain Barre, although as we will describe later in the article, some authors maintain that this clinical syndrome could correspond to a particular pathological entity.

In addition to the association of GBS with the Zika virus, it is related to gastrointestinal infections and other viral infections and a type of cancer.

The diagnosis of the disease is based above all on the clinical suspicion of a specialist in neurology, this suspicion arises after having obtained an interrogation compatible with the disease, which as we discussed above can start in the legs (although not always), and when physically examining the patient with an examination hammer we find abolition or diminution of the osteotendinous reflexes, the diagnosis is supported with the performance of a procedure called lumbar puncture.

To perform the lumbar puncture (PL) punctured in the lumbar spine (lower back), and obtain a sample of the fluid that lubricates the nervous system (cerebrospinal fluid CSF), when analyzing the liquid in the laboratory we typically find moderate increase in proteins , but normal cell and glucose count, this finding may not be present until three weeks after the onset of the disease, so it is not mandatory for confirmation of the diagnosis.

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