Guillain-Barre Syndrome

Hello and welcome back to the ThreeSpires Physiotherapy blog where we take a look at all things physiotherapy and health related. Recently we have been publishing a series of continuing articles about physiotherapy and pathologies that affect our patients. We are a home visit physiotherapy service based in Lichfield and serving areas such as Sutton Coldfield, Cannock, Tamworth, Rugeley and Walsall. In this article we will look at a rare but extremely serious neurological condition called Guillain-Barre Syndrome.

What is Guillain-Barre Syndrome?

Guillain-Barre Syndrome is a neurological condition generally characterised by extreme muscle weakness that occurs very quickly and will often necessitate a hospital admission due to the severity of symptoms. Patients with Guillain-Barre Syndrome will often initially epxerience almost complete loss of mobility and muscle strength and may need to be admitted to intensive care.

What Causes Guillain-Barre Syndrome?

The exact pathophysiolgogy of Guillain-Barre is very compex and a bit beyond the scope of this article but basically it is caused by the immune system attacking the peripheral nerves which causes a loss of signal carrying capacity of the nerves. This in turn means that the muscles served by these nerves stop working as they are not getting any signals from the brain or spinal cord. The exact causes of Guiilain-Barre Syndrome are currently unknown but often patients will have had a virus or illness prior to Guillain-Barre Syndrome and it is thought that this can trigger the immune system to mistakenly attach the peripheral nerves.

How Common is Guillain-Barre Syndrome?

Fortnately it is very rare (possibly only a couple of people per 100,000 in the population) but in extreme cases can lead to breathing difficulties and even death.

What are the Symptoms of Guillain-Barre Syndrome?

The symptoms of Guillain-Barre Syndrome as mentioned earlier are rapid onset weakness in the legs and arms (possibly with pain, numbness and tingling), some patients will have their cranial nerves affected which can cause problems with vision, swallowing and speech. In extreme cases breathing can be affected and patients will require Recovery from Guillain-Barre Syndrome is usually good but depends upon age and severity of the episode. 

Before carrying on to look at how physiotherapy might be able to help, we probably need to understand a bit more about the nerves and what happens during Guillain-Barre Syndrome. A large proportion of the peripheral nerves (those in the body and not in the brain or spinal cord) have a myelin sheath around them. This sheath allows the nerves to transmit information and electrical impulses much quicker than would be possible without the sheath. There are some nerves (un-myelinated) that do not have a myelin sheath and these transmit information much slower than those that are myelinated. During Guillain-Barre Syndrome the immune system attacks the myelin sheath that surrounds the peripheral nerves and this causes them to transmit information much more slowly and in some cases to stop transmitting any information. This problem with nerve conduction is what causes the symptoms of Guillain-Barre Syndrome such as muscle weakness.

During the acute phase of Guillain-Barre Syndrome it is most likely that a patient will be in hospital and be receivig medical treatment and intensive therapy such as physiotherapy, occupational therapy and speech and language therapy. Once this most severe phase has passed patients will usually be discharged home (once able to manage) and will receive either community physiotherapy or need to attend a neurological outpatient clinic for further rehabilitation. It is extremely important for recovery from Guillain-Barre Syndrome that physiotherapy is continued once the patient has left hospital and that there is sufficient access to physiotherapy to enable the best possible recovery to be made.

It is at this point - once discharged from hospital that our home visit physiotherapy service can help with rehabilitation and recovery from the effects of Guillain-Barre Syndrome. Our physiotherapists will be able to visit the patient with Guillain-Barre Syndrome at home and help with recovery and rehabilitation. Our physiotherapy service is based in Lichfield and serves areas such as Sutton Coldfield, Tamworth, Cannock, Burntwood, Rugeley and Walsall.

What Treatments are there for Guillain-Barre Syndrome?

In the initial period of getting Guillain-Barre Syndrome most patients will require a period of time in a hospital for assessment by doctors and a full medical team. It is important that if you suspect you have Guillain-Barre Syndrome that you seek medical advice. The following treatments are meant as options during the recovery process:

1. Occupational Therapy: an occupational therapist will be able to help with provision of any equipment needed such as mobility aids and complete an assessment of your property for a return home at some point. On assessing the property they will be looking at accessibility, ease of access to sleeping and washing areas and posible need for adaptations such as handles, stools and stair lifts.

2. Speech and Language Therapy: sometimes Guillain-Barre Syndrome can cause difficulties with swallowing and the muscles of speech and in these cases it is important to see a speech and language therapist.

3. Physiotherapy: as Guillain-Barre Syndrome mainly affects muscle strength and co-ordination getting help from a physiotherapist is vital. In the early epriod in hospital a persona with Guillain-Barre Syndrome will receive intensive physiotherapy. However the need for physiotherapy will not end once the person has returned home. Accessing regular and intensive physiotherapy is vital to making a full recovery.

4. Hydrotherapy: this can be extremely helpful to target muscles and balance work that it is too challenging to do on land for someone recovering from Guillain-Barre Syndrome.

5. Yoga & Pilates: regaining good balance, body awareness and core strength is vital after having Guillain-Barre Syndrome and finding a good Yoga or Pilates class can help with this.

6. Aerobic Exercise: after a long period in hospital many patients with Guillain-Barre Syndrome have become deconditioned and doding some form of aerobic exercise such as going for a walk can be very helpful.

7. Strengthening Exercises: as muscle weakness is a large part of Guillain-Barre Syndrome it makes sense that at some point you will need to work on your strength to make a full recovery. 

Okay, I hope that you have found this blog helpful. Guillain-Barre Syndrome is a complicated and varied condition and should you want anymore information about it then please get in touch. If you or someone you know has had Guillain-Barre Syndrome and would like help with physiotherapy then please get in touch. We can be contacted via phone: 0788 4281623 or via email: enquiries@threespiresphysiotherapy.co.uk For anyone who has not read our blog before we are a home visit physiotherapy service based in Lichfield but serving surrounding areas such as Sutton Coldfield, Tamworth, Cannock, Rugeley and Walsall.