Syndrome, Guillain-Barre

This disorder is characterized by progressive symmetrical paralysis and loss of reflexes, usually beginning in the legs. There is, in most cases, nearly complete or complete recovery. The Guillain-Barre syndrome is not associated with fever. There is paralysis involving more than one limb, most commonly the legs, and that paralysis is progressive. There is areflexia (loss of reflexes) or hyporeflexia (diminution of reflexes) in the legs and arms. Other conditions that may mimic the Guillain-Barre syndrome need to be ruled out. Usually occurring after a respiratory infection, it is caused by a misdirected immune response that results in the direct destruction of the myelin sheath surrounding the peripheral nerves, or of the axon of the nerve itself. The syndrome sometimes follows other triggering events, including vaccinations. Among the vaccines reportedly associated with Guillain-Barre syndrome are the 1976-1977 swine flu vaccine, oral poliovirus vaccine, and tetanus toxoid. Aside from vaccinations, infection with the bacteria Campylobacter jejuni and viral infections can trigger Guillain-Barre syndrome. Other conditions that may mimic the Guillain-Barre syndrome need to be ruled out before diagnosis is made. Treatment is by plasmapheresis or intravenous gamma globulin (IGG). See also demyelination, Landry’s paralysis.