Guillain-Barre Syndrome

This disease is characterized by an acute onset, it mainly affects the peripheral nervous system and the spinal roots, which is accompanying by dissociation of proteinous cells in cerebrospinal fluid (CSF) or the elevation of protein level in CSF. It is also called Guillain-Barre syndrome. People from any ages, male or female, are susceptible to this illness, but it is mostly seen in male (youth and adult). The cause factor and pathogenesis are not fully revealed yet, generally, it is preceeded by infectious illness (acute influenza-like illness) and may has history of vaccination, that induces delayed hypersensitivity reaction and immune-mediated disease, the most important pathologic changes is the segmental inflammatory which caused demyelination of peripheral nerves. Before the symptomatic signs of the disease, it is featured by inflammatory disease of upper respiratory tract or digestive tract about 1-4 weeks , or the patient has the history or vaccination. This disease can happens in four seasons, but mostly in summer and autumn. The unique clinical manifestation appears after 1-3 weeks of contraction of unfectious disease that is characterized by sudden appearance of strong pain in root of nerves (mostly in neck, shoulder, waist and lower extremities), acute progressive symmetrical paralysis or the ascending paralysis, disturbances in sensory function, decreased or absence of reflexes. Among those significant signs are (1) movement disturbances: the main symptom is paralysis of extremities and trunk. Generally, it starts from the lower limbs, then, gradually affects the trunk and upper limbs and cranial nerves, it can happens from a side to another side. Normally, the disease reaches the peak within 1-2 weeks. The paralysis is more serious in the distal part and shown weakness of muscle contraction, e.g breathing, swallowing, talking, all these can lead to paralysis of spontaneous breathing, difficulty in swallowing and speech pronounciation which later do harm to life. (2) disturbances in sensory function: the light degree, basically, starts from distal prt of extremities with feeling of numbness or prickling sensation. One may also has decreased, disappeared or sensitive to sock-like sensation and spontaneous pain, compression pain which is obvious at intestinal muscle and muscle of anterior abdominal wall. (3) relexes disturbances: reflexes of limbs are usually decreased or disappeared, abdominal and testicular reflexes are kept. A minority of pateints may even have pathological reflexes due to affection of spinal cord. (4) disturbances in vegetative nervous system: in early stage of disease or recovery period, one has excessive sweating and strong odour of sweat, it may be due to cross stimulation of sensory nerves. Minority of patients may have retention of urine due to imbalance of innervation of vegetative nervous system or damage of spinal nerves that innervate muscle of the urinary bladder; constipation; some patients may also have unstable blood pressure, increased heart rate (tachycardia), abnormality in ECG and etc. (5) cranial nerve (CN) symptoms: about half of the patients will have cranial nerves damage; damage of CN 9 or glossopharyngeus nerve for swallowing, CN 10 vagus nerve, CN 12 hypoglossal nerve, one side of both side of CN 5 facial nerve damage which affect it s surrounding innervation. Then, followed by CN 3 oculomotor nerve, CN 4 trochlear nerve and CN 6 abducent nerve. Sometimes, may encounter with neurogenic edema in the nipple which is a result of inflammation in the nerves or due to brain edema, significant elevation of protein in CSF which block the way to subarachnoid space and later affects the absorption of CSF. The diagnosis is based on sudden appearance of symmetrical decreased sensation in distal part of limbs after acute infectious illness, movements and nutritional disturbances and disappearance of reflexes. The western medical treatment emphasizes on elimination of pathological factor, rehydration treatment, nerve s nutrition and symptomatic therapy. The traditional chinese medicine (TCM) classified this disease in the category of wei zheng (symptom of atrophy). The cause factors include heaty dampness and moist heat; the pathogenesis is moist heat that overflooded the jing mai (route of vessels), after a long time, it caused damage to liver, kidneys, spleen and leads to exhaustion of blood elements, abnormality in muscles and bones; the treatment is focused on the clearance of heat, elimination of moist, rehydrate the heatiness, relaxing the muscles and bones, improve blood circulation, renourish Qi , strengthen the spleen, liver and kidneys, cultivate more Jing (elements), eliminate atrophy and etc.Clinical treatment resultsThere were 37 cases adopted the TCM treatment ( 1 case cessated treatment half way); all 36 cases recovered clinically. The effectiveness is shown averagely in 10 days and recovered in 1-2 months.