brain, spinal cord, and nerve disorders
Guillain Barré Syndrome (GBS)
Treatment of GBS
Hospitalization and supportive care If needed, use of a ventilator to help with breathing Immune globulin or plasma exchange Guillain-Barré syndrome can worsen rapidly and is a medical emergency. People who develop this syndrome should be hospitalized immediately. The sooner appropriate treatment is started, the better the chance of a good outcome. If symptoms strongly suggest Guillain-Barré syndrome, treatment is usually started without waiting for test results. In the hospital, people are closely monitored so that breathing can be assisted with a ventilator if necessary. People with weak facial and neck muscles may need to be fed through a catheter inserted in a vein ( Intravenous Feeding ) or through a tube placed directly into the stomach (a gastrostomy tube) or small intestine (a percutaneous endoscopic gastrostomy or Being unable to move because muscles are weak can cause many problems, such as Pressure Sores and stiff, permanently shortened muscles (contractures). So nurses take precautions to prevent pressure sores and injuries by providing soft mattresses and by turning the people with severe weakness every 2 hours. Physical therapy is started to help prevent contractures and preserve joint and muscle function and the ability to walk. Heat therapy may be used to make physical therapy more comfortable. Physical therapy may begin with the therapist moving the limbs for people (passive exercise). As the weakness subsides, people should move their own limbs (active exercise). Immune globulin (a solution containing many different antibodies collected from a group of donors), given early and by vein (intravenously) for 5 days, is the treatment of choice for Guillain-Barré syndrome. If immune globulin is ineffective, Plateletpheresis (platelet donation) (filtering of toxic substances, including antibodies to the myelin sheath, from the blood) can help. These treatments shorten the hospital stay, speed recovery, and reduce the risk of death and permanent disability. Plasma exchange is usually done as soon as possible if people are worsening quickly. However, removing and replacing a lot of blood through a tube (catheter) inserted in a vein can cause low blood pressure and increase the risk of infection. Because plasma exchange removes immune globulin from the blood, plasma exchange is not used at the same time as immune globulin. Plasma exchange is delayed for at least 2 to 3 days after immune globulin is given. Corticosteroids do not help and may worsen Guillain-Barré syndrome. 