What Causes Guillain-Barre Syndrome?

What Is Guillain-Barre Syndrome (GBS)?

Guillain-Barre syndrome can also be referred to as “acute inflammatory demyelinating polyneuropathy” and “Landry’s ascending paralysis.” GBS is a rare neurological inflammatory disorder of the peripheral nerves that are located outside the brain and spinal cord. As a result, this can lead to a rapid onset of numbness, weakness, and paralysis of the legs, arms, breathing muscles, and face. The term “paralysis” means the complete or partial loss of body muscle function. [1] 

GBS can affect any patient population; both males and females are equally at risk, and GBS can occur at any age onset. However, it seems to be more prevalent in adults and older individuals. It is estimated to affect roughly 1 in 100,000 people per year. 

What Are The Different Types Of Guillain-Barre Syndrome?

There are several variants of GBS, and rapid onset is a characteristic shared by all of them: 

• Acute inflammatory demyelinating polyneuropathy (AIDP): This “classic” variant accounts for 75% – 80% of cases.
• Acute motor axonal neuropathy (AMAN): This variant is similar to AIDP, but does not exhibit sensory symptoms.
• Acute motor sensory axonal neuropathy (AMSAN): This severe variant of GBS is more prevalent in China, Japan, and Mexico.
• Miller Fisher syndrome: Characterized by double vision, loss of balance, and deep tendon reflexes [1].

Causes of Guillain-Barre Syndrome

The exact cause of Guillain-Barre syndrome is still not well established. However, most cases commonly occur within a few days or weeks following a respiratory or gastrointestinal viral infection. Studies have shown that such infections can trigger an autoimmune response. Normally, the immune system uses antibodies (molecules produced in an immune response) and special white blood cells to protect us by attacking infecting microorganisms (bacteria and viruses). However, in GBS, the immune system mistakenly attacks the healthy nerves. The term “autoimmune” is used because the patient’s immune system of antibodies and white blood cells attack the body, causing damage to the myelin (nerve cell covering or insulation) which can lead to numbness and weakness [1]. 

The following infections or conditions may trigger an autoimmune response:

• Bacteria
  • Campylobacter jejuni, which causes diarrhea (often from undercooked infected chicken)
  • Haemophilus influenzae, which causes chest infection
• Viruses
  • Cytomegalovirus, which causes chest infection or glandular fever
  • Epstein-Barr virus, which causes glandular fever
  • Hepatitis E, which causes jaundice
  • Zika virus, which causes fever, rash, and joint pain
  • SARS-Cov-2, which is the cause of the COVID-19 pandemic: GBS has occurred after COVID-19 but it is not yet clear whether this is a coincidence. 
• Surgery and vaccinations, which in rare cases may increase the risk of GBS [3].

Conclusion

The exact and specific causes of Guillain-Barre syndrome are still unknown at this time. GBS is related to the immune system response following an infection. Prior infections or illnesses may play a vital role in the development of Guillain-Barre syndrome.