What to know about Guillain-Barré syndrome
Guillain-Barré syndrome is a rare nerve disorder making headlines because of a possible link to the Zika virus.
Guillain-Barré syndrome is part mystery. Doctors do not fully understand what causes the disorder. They do know that a person’s own immune system attacks and damages nerve cells. The illness now is making news because researchers are seeing a strong association between Zika virus infections and Guillain-Barré.
The link between the mosquito-borne Zika virus, pregnant women and babies born with abnormally small heads and brains (microcephaly) has made headlines worldwide in recent months, as infections have spread and travel advisories have been issued for heavily affected areas.
The overall risk for Guillain-Barré syndrome is very small, but this new association shows that neurologic conditions associated with the virus may affect anyone infected with Zika.
Zika and Guillain-Barré syndrome
Guillain-Barré syndrome is rare, with about 3,000 to 6,000 cases reported each year in the U.S. As the Zika virus has spread across Central and South America, the World Health Organization has reported a rise in cases of Guillain-Barré syndrome.
“Based on a growing body of preliminary research, there is scientific consensus that Zika virus is a cause of microcephaly and Guillain-Barré syndrome,” said a Zika situation report published by the World Health Organization on April 7, 2016.
“This report is likely to be the tip of the iceberg,” said Vanderbilt infectious disease expert William Schaffner, M.D., in Medscape Medical News. “I think physicians who come across new suspected cases of Guillain-Barré syndrome should ask patients if they have been to Zika countries. That may help with diagnosing the conditions.”
Just because research is showing a link between Zika and Guillain-Barré does not mean people who are infected with the virus will get the syndrome. “Because the rise in cases of Zika infection has been so recently identified, the risk of GBS associated with the virus is difficult to estimate,” said Bryan Burnette, M.D., associate professor in the Vanderbilt Department of Neurology. “However, the CDC reports only one case of Guillain-Barré syndrome in a Zika-infected person in the continental U.S. since the beginning of 2015. All cases of Zika infection identified during that period (about 350 cases in total) were associated with travel to areas outside the contiguous U.S. where the virus is endemic.”
Symptoms of Guillain-Barré syndrome can appear after infections, surgery or trauma. People of any age and both genders are equally prone to the syndrome, although it is very rare in children under 2. It often starts with tingling or weakness in the legs or feet that can spread upward to the hands. It can progress to full-body muscle weakness, pain and even temporary paralysis. In rare cases, the illness can lead to death. Symptoms can last a few weeks to many months. Some patients describe the feeling of paralysis like being encased in clay.
Guillian-Barré is called a syndrome and not a disease because doctors are usually unable to identify a specific infection as a cause. Instead, patients are questioned about their symptoms. Guillain-Barré syndrome appears more rapidly than other nerve disorders and symptoms almost always affect both sides of the body equally. Nerve conduction studies can help doctors discover if nerve damage is consistent with the illness. Sometimes doctors will perform a spinal tap to test spinal fluid for specific proteins seen in Guillain-Barré syndrome.
There is no cure for Guillain-Barré syndrome. The goal for treating patients is to reduce the symptoms and keep their body functioning until the nervous system recovers. Treatments such as plasmapheresis or immunoglobulin administration may be used to suppress further injury to peripheral nerves caused by the immune system’s response to the infectious trigger. Plasmapheresis is a procedure which removes the plasma (liquid part of the blood) and replaces it with other fluids. Antibodies are also removed with the plasma, which is thought to help reduce symptoms.