Treatment for Guillain-Barre syndrome (GBS)
The most critical part of treatment for GBS involves keeping a person’s body functioning during recovery of the nervous sytem.
There is no known cure for Guillain-Barré syndrome (GBS). The most critical part of the treatment for this syndrome consists of supportive care directed at keeping the person’s body functioning during recovery of the nervous system. This can sometimes require placing the affected person on a respirator, a heart monitor, or other machines that assist body function. The need for this sophisticated machinery is one reason why people are usually treated in hospitals, often in an intensive care ward.
In the hospital, doctors can also look for and treat the many problems that can afflict any paralyzed person - complications such as pneumonia, pressure ulcers (bed sores) and deep venous thrombosis (blood clots). Often, even before recovery begins, caregivers may be instructed to manually move the affected person’s limbs to help keep the muscles flexible to avoid contractures and to keep muscles strong. Later, as the individual begins to recover limb control, physical therapy begins.
Disease-modifying therapies are available that significantly lessen the severity of the illness and accelerate the recovery in most people. Currently, plasma exchange (also known as plasmapheresis) and high-dose immunoglobulin therapy are used. Both of them are equally effective, but immunoglobulin is easier to administer. The combination of both therapies is not superior to either method. Plasma exchange is a method by which whole blood is removed from the body and processed so that the red and white blood cells are separated from the plasma, or liquid portion of the blood. The blood cells are then returned to the patient without the plasma, which the body quickly replaces. Scientists still do not understand exactly how plasma exchange works, but the technique seems to reduce the severity and duration of the Guillain-Barré syndrome episode. This may be because the plasma portion of the blood contains elements of the immune system that may be toxic to myelin.
In high-dose immunoglobulin therapy, doctors give intravenous injections of the proteins that, in small quantities, the immune system uses naturally to attack invading organisms. Immunoglobulin is derived from a pool of thousands of normal donors. Investigators have found that giving high doses of immunoglobulin to Guillain-Barré syndrome patients can lessen the immune attack on the nervous system but the precise mechanism of action is unknown.
The use of steroid hormones has also been tried as a way to reduce the severity of Guillain-Barré syndrome, but controlled clinical trials have demonstrated that this treatment not only ineffective but may even have a harmful effect. Carefully planned clinical trials of new and experimental therapies are the key to improving the treatment of persons with Guillain-Barré syndrome.