Guillain-Barré Syndrome – Topic Overview

In the hospital, you may get a plasma exchange or intravenous immune globulin (IVIG).

In a plasma exchange, blood is taken out of your body. The harmful antibodies are removed from the blood, and then the blood is returned to your body.
In IVIG, helpful antibodies are added to your blood.
These treatments may help your body fight the disease and may speed your recovery if they are used when you first get GBS.

You may need 3 to 6 months or longer to recover from GBS. And sometimes GBS can come back.

If you had severe muscle weakness, you may need physical or occupational therapy. You will also need exercise to help you regain muscle strength and movement. You may need help with daily tasks for a while.

Guillain-Barré Syndrome – Treatment Overview

The main treatment for GBS is preventing and managing complications (such asbreathing problems or infections) and providing supportive care until symptoms begin to improve. This may include:

Easing your breathing problems, sometimes through the use of a breathing machine (ventilator).
Monitoring your blood pressure and heart rate.
Providing adequate nutrition if you have problems chewing and swallowing.
Managing bladder and bowel problems.
Using physical therapy to help maintain muscle strength and flexibility.
Preventing and treating complications such as pneumonia, blood clots in the legs, or urinary tract infections.
Other treatment of Guillain-Barré syndrome (GBS) depends on how severe your symptoms are. More severe cases of GBS are treated with immunotherapy, which includes plasma exchange or intravenous immune globulin (IVIG). Treatment is given in a hospital. It starts immediately after you have been diagnosed with GBS that is getting worse. Early intervention with either of these treatments appears to be effective and may reduce recovery time. Neither treatment is better than the other, and there is no benefit to combining these treatments.2

Careful monitoring is very important during the early stages of GBS because breathing problems and other life-threatening complications can occur within 24 hours after symptoms first start.

Admission to a hospital or intensive care unit is often needed when muscle weakness progresses quickly. Muscle weakness may rapidly affect the muscles that control breathing. In such cases, temporary use of a mechanical ventilator may be necessary to help you breathe until you can breathe on your own again.
Careful outpatient monitoring may be enough in cases where significant muscle weakness has not developed. It is important to continue to watch closely for any signs that the condition is getting worse so that you can contact your doctor or hospital immediately.
You probably will need to be hospitalized if you:

Are unable to move around on your own.
Have significant paralysis.
Have breathing problems.
Have blood pressure problems or an abnormal, very fast, or very slow heart rate.
If possible, you will be referred to a medical center that has experience treating the illness.

Recovery

Recovery may take 3 to 6 months, sometimes longer-in some cases, up to 18 months. People who have severe muscle weakness may need to stay at a rehabilitation hospital to receive ongoing physical therapy and occupational therapy as their motor function returns. For those who stay at home, devices that help perform certain daily activities can be used until motor function and muscle strength return.

Physical therapy and regular exercise are needed throughout the recovery period to strengthen the weakened muscles. The therapy program can be made to fit your specific needs.

Although recovery can be slow, most people who have GBS eventually recover.

Many people have some minor long-term effects, such as numbness in the toes and fingers. In most cases, these problems will not significantly interfere with your lifestyle.
About 20% of people have permanent problems that tend to be more disabling, such as weakness or balance problems. These problems may interfere with daily activities.3
About 3% to 8% of people who develop GBS die from complications of the illness, such as respiratory failure, infection (often pneumonia), or heart attack.3
Up to 67% of people who get GBS have some problems with persistent fatigue.2
Relapses

Relapses or repeated episodes of GBS happen in about 5% to 10% of cases, and they may be very serious. If you have a relapse, aggressive treatment with plasma exchange or IV immune globulin may reduce the severity of the attack and prevent further relapses. If you have more than one relapse, treatment with other drugs may be needed.

Hallucinations
Related To Category : Adult

Hallucinations involve sensing things – whether visual (sight), auditory (hearing), olfactory (smell), or gustatory (taste) – while awake that appear to be real, but instead have been created by the mind.

Common hallucinations include:
Feeling bodily sensations, such as a crawling feeling
Hearing sounds
Hearing voices (the most common type of hallucination). The voices heard may criticize or compliment the individual or they may be neutral in tone. Voices heard have also been known to command the individual to do something potentially harmful.
Seeing patterns, lights, beings, or objects
Smelling a foul or pleasant odor
In some cases however, hallucinations may be normal. For example, as part of the grieving process it is possible that one can hear the voice of, or briefly see, a loved one who has recently died.
Headache
Related To Category : Adult

What is a headache?
Headache is defined as pain in the head or upper neck. It is one of the most common locations of pain in the body and has many causes.

How are headaches classified?
Headaches have numerous causes, and in 2007 the International Headache Society agreed upon an updated classification system for headache. Because so many people suffer from headaches, and because treatment is sometimes difficult, the new classification system allows health care practitioners to understand a specific diagnosis more completely to provide better and more effective treatment regimens.

There are three major categories of headaches:

primary headaches,
secondary headaches, and
cranial neuralgias, facial pain, and other headaches
What are primary headaches?
Primary headaches include migraine, tension, and cluster headaches, as well as a variety of other less common types of headache.

Tension headaches are the most common type of primary headache; as many as 90% of adults have had or will have tension headaches. Tension headaches are more common among women than men.

Migraine headaches are the second most common type of primary headache. An estimated 28 million people in the United States (about 12% of the population) will experience migraine headaches. Migraine headaches affect children as well as adults. Before puberty, boys and girls are affected equally by migraine headaches, but after puberty, more women than men are affected. An estimated 6% of men and up to 18% of women will experience a migraine headache.

Cluster headaches are a rare type of primary headache, affecting 0.1% of the population. An estimated 85% of cluster headache sufferers are men. The average age of cluster headache sufferers is 28-30 years of age, although headaches may begin in childhood.

Primary headaches affect quality of life. Some people have occasional headaches that resolve quickly, while others are debilitated. Tension, migraine, and cluster headaches are not life-threatening.

What are secondary headaches?
Secondary headaches are those that are due to an underlying structural problem in the head or neck. There are numerous causes of this type of headache ranging from bleeding in the brain, tumor, or meningitis and encephalitis.

What causes tension headaches?
While tension headaches are the most frequently occurring type of headache, their cause is not known. The most likely cause is contraction of the muscles that cover the skull. When the muscles covering the skull are stressed, they may spasm and cause pain. Common sites include the base of the skull where the trapezius muscles of the neck inserts, the temple where muscles that assist the jaw to move are located, and the forehead.

There is little research to confirm the exact cause of tension headaches. Tension headaches occur because of physical or emotional stress placed on the body. Physical stress that may cause tension headaches include difficult and prolonged manual labor, or sitting at a desk or computer for long periods of time Emotional stress may also cause tension headaches by causing the muscles surrounding the skull to contract.

What are the symptoms of tension headaches?
The symptoms of tension headache are:

A pain that begins in the back of the head and upper neck as a band-like tightness or pressure.
Described as a band of pressure encircling the head with the most intense pain over the eyebrows.
The pain is usually mild (not disabling) and bilateral (affecting both sides of the head).
Not associated with an aura (see below) and are not associated with nausea,vomiting, or sensitivity to light and sound.
Usually occur sporadically (infrequently and without a pattern) but can occur frequently and even daily in some people.
Most people are able to function despite their tension headaches.
What diseases cause secondary headaches?
Headache is a symptom associated with many illnesses. While head pain itself is the issue with primary headaches, secondary headaches are due to an underlying disease or injury that needs to be diagnosed and treated. Controlling the headache symptom will need to occur at the same time diagnostic tests are being considered. Some of the causes of secondary headache may be potentially life-threatening and deadly. Early diagnosis and treatment is essential, if damage is to be limited.

The International Headache Society lists eight categories of secondary headache. A few examples in each category are noted (this is not a complete list):

Head and neck trauma

Injuries to the head may cause bleeding in the spaces between the layers of tissue that surround the brain (subdural, epidural and subarachnoid bleeding) or within the brain tissue itself.
Concussions, where head injury occurs without bleeding
A symptom of whiplash and neck injury
Blood vessel problems in the head and neck

Stroke or transient ischemic attack (TIA)
Arteriovenous malformations (AVM) may cause headache before they leak.
The carotid artery in the neck can become inflamed and cause pain.
Temporal arteritis (inflammation of the temporal artery)
Non-blood vessel problems of the brain

Brain tumors, either primary, originating in the brain or metastatic from a cancerthat began in another organ
Seizures
Idiopathic intracranial hypertension, once named pseudotumor cerebri, where there is too much cerebrospinal fluid pressure within the spinal canal.
Medications and drugs (including withdrawal from those drugs)