What is GBS?

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Early Treatment

As of this writing, specific treatments that might predictably halt or reverse the disorder have not been definitely established although plasmapheresis now appears to have a definite role in some cases. Two avenues of therapy have been tried, corticosteroids (kor-ti-co-steer-oids) and plasmapheresis (plaz-ma-fer-eace-is).

High doses of corticosteroids, hormones normally made by adrenal gland (above the kidney) have been used with varying results. Their value is still questionable. A large study conducted in England indicated that corticosteroids are not beneficial.

Plasmapheresis, a process in which some of the patient's blood is removed, the liquid part separated, and the blood cells returned to the body, has been used for severe cases. The co-operative study undertaken in the US seems to indicate that patients treated early in their illness generally will recover more rapidly than those untreated but other factors including the age of the patient and accessibility of plasmapheresis need to be considered.

Most other treatments are directed at preventing or treating the complications of Guillain-Barré syndrome. For example, the paralysed patient, at bed rest, is prone to several problems that can be prevented.

Frequent turning, a foam mattress cover or special bed that enables changes of body position, helps to prevent bedsores (skin breakdown over bony prominences). Blood flow tends to be slow in the leg and pelvic veins of paralysed patients and the use of blood thinners helps to prevent formation of clots in veins and their travel to the lungs. Leg swelling, related to paralysis and fluid accumulation can be relieved by leg elevation, special (TED) stockings and other techniques.

Should abnormalities of the body's internal organs develop, appropriate treatments are available. Constipation can be relieved with bowel softeners or other drugs. Abnormal blood pressure or heart beat can also be treated by several medications. Retention of urine may require bladder drainage with a catheter, called a Foley.

If muscles used for breathing become too weak, a tube is passed into the airway (trachea), and connected to a breathing machine or mechanical ventilator (eg. Bennet MA-1). Should these steps be required, various methods are used to clear the lungs of secretions and help prevent pneumonia. Because patients on a respirator cannot speak, they may need alternate methods to communicate with hospital personnel and family. If the hands are strong enough, a pencil and paper on a clipboard can be used. The extremely weak patient can be instructed to use a simple code system such as eye blinks or finger taps to signal "yes" or "no" responses. Even the weakest patient can usually still hear quite well, even if completely paralysed. Thus they may still benefit from words of encouragement and explanation of activities around them. Mechanical support of breathing is continued until sufficient strength of required muscles has returned. Various methods are used to determine that strength is adequate to allow unassisted breathing and weaning from a respirator.