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- 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!