Treatment for Guillain-Barre syndrome (GBS)
There is no known cure for Guillain-Barre syndrome (GBS). However, there are therapies that lessen the severity of the illness and accelerate the recovery in most people. There are also a number of ways to treat the complications of the disease.
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. 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 don’t know exactly why plasma exchange works, but the technique seems to reduce the severity and duration of the GBS episode. This may be because the plasma portion of the blood contains elements of the immune system that may be toxic to the 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. Immunoglobulines are derived from a pool of thousands of normal donors. Investigators have found that giving high doses of these immunoglobulins to GBS patients can lessen the immune attack on the nervous system.
The use of steroid hormones has also been tried as a way to reduce the severity of GBS, but controlled clinical trials have demonstrated that this treatment not only is not effective but may even have a harmful effect.
The most critical part of the treatment for this syndrome consists of 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 or bed sores.
Often, even before recovery begins, caregivers may be instructed to manually move the affected person’s limbs to help keep the muscles flexible and strong. Later, as the individual begins to recover limb control, physical therapy begins. Carefully planned clinical trials of new and experimental therapies are the key to improving the treatment of persons with GBS.