Guillain-Barré Syndrome is diagnosed by its symptoms and tests. Symptoms are bilateral progressive weakness, tingling, numbness, paralysis, and pain that usually starts in the feet and works its way toward the head. Loss of deep tendon reflexes (DTR), which are your reflexes such as knee kick or the elbow. Organ paralysis such as the lungs, which require being hooked up to a breathing machine.

 

Spinal tap is usually done to see if there are elevated proteins in the spinal fluid. Elevated proteins do not always show up in the first week. A Nerve Conduction Velocity (NCV) test may be done, which can show whether it is demyelinating, axonal, or a mix.

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The hospital care is dependent on the hospital or care center available to the person.  Usually, the person will either go to the emergency room or their doctor, and their doctor will send them to a neurologist. Because GBS is considered a medical emergency, usually a patient who is admitted is placed in the Intensive Care Unit (ICU) and monitored closely. After being admitted and becoming stable they may move the patient into a different area in the hospital that meets the new needs of the patient.

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A problem that we faced with Annette was that neither the emergency room doctor nor the hospital doctor knew she had GBS. The ER doctor wanted to release her until they tried to get her up to walk using a walker (she walked fine before the GBS) but suddenly she could no longer walk, therefore, she was admitted to the hospital. The next day the hospital doctor said he thought “it was all in her head” and wanted to do a psych evaluation. Not until the right side of her face started to droop did he consider calling a neurologist. If nurses have never dealt with GBS they may not understand the needs of the patient. It may be up to the patient, the patient’s family or friends, or an advocate to get the right care.

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There are two main treatments for Guillain-Barré Syndrome. One is Plasma exchange (PE) or plasmapheresis. PE is dialysis, it removes the bad plasma in the blood and replaces it with good donor plasma or synthetic. The procedure will start with a central line being placed in the neck or groin. Next, the blood is removed and spun to remove the plasma and then returned to the body. There are usually a set of treatments done and the doctor will determine how many treatments are right for each patient. The second treatment is high dose immunoglobulin (IVIG). IVIG is a high dose of antibodies purified from the plasma of a donor. IVIG is given through an IV (intravenously). There are other drugs being used like corticosteroids and others that are still investigational.