Is neuropathy associated with guilain barre syndrome treatable and if so, how do I treat it and relieve the painful symptoms? My neurosurgeon just informed me that I have g.B.S. And had it since may 2011 following a stomach flu I had 2 weeks before my sym
Your . Your case presents a few dilemmas. Gbs is a group of autoimmune diseases targeted at the peripheral nerves and causing acute progressive weakness, usually an ascending paralysis. The history usually entails the following: â€¢upper respiratory or diarrheal disease within previous 1â€“3 weeks in 50â€“70%: c. Jejuni (~40%), cytomegalovirus (13%), epstein-barr virus (10%), mycoplasma pneumoniae (5%), or hiv â€¢dysesthesias (painful tingling), paresthesias (tingling) of the feet and hands are usually the earliest symptoms. â€¢pain is common- especially back pain which can radiate to the legs and not usually associated with myalgias (muscle pain). â€¢gait disorder common in all age groups- this is the most common presentation in children â€¢neck muscle weakness, dysphagia, and dysarthria are predictors of respiratory failure. The physical exam frequently reveals the following: â€¢acute, symmetric, and usually ascending weakness of limbs within days of dysesthesias â€¢areflexia (no reflexes) or hyporeflexia( reduced reflexes) and muscle weakness, decreased position and vibratory sensation â€¢respiratory muscle paralysis 30% if untreated â€¢cranial nerve involvement <50%; usually facial weakness, 10â€“20% ophthalmoparesis (loss of eye movement) â€¢dysautonomia (abnormal autonomic nervous system responses) (50%): labile blood pressure, arrhythmias, ileus (paralysis of bowel function), urinary retention; â€¢miller-fisher variant: ophthalmoplegia, ataxia, areflexia important lab tests â€¢csf: elevated protein and normal white blood cells (wbcs; albuminocytologic dissociation) are characteristic with a normal opening pressure. â€¢emg: this shows a pattern of demyelination with prolonged latencies and a reduced motor compound action potential. The medications usually used are one or more of the following: â€¢immune globulin (ivig) â€¢plasmapheresis or plasma exchange most patients reach the plateau phase within 3 weeks of admission, and muscle strength is expected to improve. The prognosis is: â€¢complete recovery: 50% â€¢some residual disability: 45% â€¢severe permanent disability: 5% hence, the dilemma as you report no improvement and in fact worsening. Furthermore, a lesion within the spinal cord (myelopathy) can present with similar symptoms as the ones you provide. A few pertinent questions to help discern the cause would include whether you have had a lumbar puncture and EMG and what did these results show? I hope this answers your questions. Good luck and well wishes.
As . As dr mccarren has written, your case description is atypical for guillain-barre syndrome, although we would not rule out the diagnosis from what you have said. However, your history of neck trauma and of a spinal lesion in the cervical region raises the question as to how much of your problem, particularly the sensory loss from the legs, might be due to spinal cord compression from a bony growth, or from other degenerative changes, in the cervical spine. This needs a thorough evaluation from a neurologist and/or a neurosurgeon after a good MRI examination, since you may have a treatable problem and not a progressive degenerative or autoimmune disease.