Presentation on Guillain-Barre Syndrome

1. Guillain-Barré Syndrome
Final Project- Understanding the Brain:The Neurobiology of
Everyday Life
By- Debopriya Choudhury

2. What is Guillain-Barré Syndrome?
• Rare neurological disorder in which the body's immune system attacks its peripheral
nervous system
• It affects nerves outside of brain and spinal cord
• GBS affects people of any age
• Causes muscle weakness and can even lead to paralysis
• Most people recover but some have permanent nerve damage
• Jean-Baptiste Octave Landry described the disorder in 1859 but the main diagnostic
abnormalities were described by Georges Guillain, JeanAlexandre Barré andAndré Stohl

4. Causes of GBS• Exact cause is not known
• Symptoms can appear after a respiratory or digestive tract infection
• Risk factors- It can increase with age, more common in males
• Can also be triggered by-
Campylobacter
HIV
Cytomegalovirus
InfuenzaVirus
ZikaVirus
Hepatitis A,B,C,EVirus
Surgery/Trauma
Epstein-BarrVirus

5. Types of GBS
Acute Inflammatory
demyelinating
polyradiculoneuropathy (AIDP)
Miller Fisher Syndrome (MFS) Acute motor axonal neuropathy
(AMAN)
Common in North America and
Europe
More common in Asia Frequently found in China, Japan
and Mexico
Muscle weakness starts in lower
part of body and spreads upward
Paralysis starts in the eyes, also
associated with unsteady gait
Acute paralysis and loss of reflexes
without sensory loss

6. Symptoms of GBS
• Tingling in the feet or hands
• Weakness on both sides of the body
• Difficulty with eye muscles and vision
• Difficulty swallowing, speaking or chewing
• Pricking sensations in hands and feet
• Coordination problems
• Abnormal heart rate or blood pressure
• Digestive or bladder problems

7. Mechanism/s of nerve damage
Molecules on some nerves are similar to or mimic molecules present
on certain microbes, thus triggering the immune system to attack
them
In many cases, the preceeding infection makes the body's immune
system less discriminating to own and foreign molecules and theT-
cells and B-cells together make antibodies against myelin present
on nerve fibre

8. Mechanism/s (continued)
• In the axonal subtype of GBS, the antibodies attack gangliosides found on
peripheral nerves
• Antibodies have been found against four types of gangliosides-
GM1, GD1a, GT1a, GQ1b
• GQ1b associated with Miller Fisher subtype of GBS
• In a group of people, following a Campylobacter infection, IgG antibodies are
made (against lipooligosaccharides of bacteria) which cross react with
gangliosides

9. Diagnosis
• Findings such as absence of reflexes, muscle paralysis and absence of likely
cause
• Blood tests to exclude possibility of other causes
• Lumbar puncture- elevated protein levels in CSF, lowWBC count
• Nerve conduction tests- Axonal poluneuropathy, reduced conduction may
be found
• Anti- GQ1b antibody levels tested to determine subtype( MFS)

10. Treatment
• Most are treated in Hospitals
• Intravenous Immunoglobulin(IVIG)- to bring the immune system under
control
• Plasma exchange(plasmapheresis)- to filter the blood to remove substances
which attack the nerve fibres
• Painkillers to manage associated pain
• Breathing and/or feeding tube in case of respiratory or digestive
complications

11. New Research advancements
• Molecules like Glatiramer acetate, quinpramine, fasudil, flecainide have
shown promises in animal models
• Antibody against anti-GD3 antiganglioside antibody has shown good results
in lab studies
• New mouse model with altered autoimmune regulator gene developed to
understand which peripheral nervous system proteins are at greater risk of
autoimmune attack and which components of the immune system
contribute to it

12. References
• www.mayoclinic.org
• www.ninds.nih.gov
• www.wikipedia.org
• www.nhs.uk
• www.who.int
• www.gbs-cidp.org
• www.medinaz.com

13. Thank you!