Guillain–Barré syndrome

Medico-legal guidance for solicitors

Guillain–Barré syndrome (GBS) is a medical condition where an individual experiences symptoms of muscle weakness that are rapid in onset and frequently severe. It is caused by a malfunction in the person’s own immune system that attacks the peripheral nervous system. The exact cause of the onset of this autoimmune attack is unknown but the illness is usually triggered by an episode of flu, or a gastrointestinal or respiratory infection.

The patient initially presents with typical changes in sensation, pain or muscle weakness and tingling, starting in the hands and feet. This often spreads to the arms and moves upwards towards the upper part of the body on both sides. The symptoms can develop over hours to a few weeks and may include pain, prickling sensations, weakness, a rapid heart rate, difficulty breathing, difficulty with the control of bladder and bowel. As the disease progresses, the muscle weakness evolves into the paralysis of the muscles spreading from the lower to the upper half of the body.

During the acute phase of the disease, Guillain–Barré syndrome can be life-threatening. About 15% of those suffering from GBS develop weakness of the muscles involved in controlling breathing movements, which leaves them at risk of experiencing respiratory distress.

This emergency condition requires prompt hospitalisation and temporary support from a ventilator machine until the acute episode subsides. Some patients can be affected by changes in the function of the autonomic nervous system, which can lead to abnormalities in the heart rate and rapid and wide fluctuations in the blood pressure. Because of this uncontrolled, irregular rise and fall in blood pressure, these individuals may also require immediate hospital treatment.

In the acute phase, the muscle weakness and paralysis can be of such great intensity that many patients find it difficult to walk, transfer from one spot to another, sit, feed themselves or go to the toilet without assistance. This inability and dependency may last weeks or months before recovery starts.

The rate and extent of recovery from GBS is highly variable - from being able to walk independently to incomplete or delayed motor recovery. Many patients are left with a significant impairment of distal muscular function, which often causes profound long-term disability of hand function, commonly complicated by upper limb flexion contractures. In the long run, this condition can also leave the patient permanently incapable of walking without an aid, or incapable of maintaining balance and coordination.

The complications of this autoimmune condition make it important that the management and neurorehabilitation is carried out by expert teams. Recovery depends on the individual and is supported by counselling and physiotherapy. Physiotherapy aims to relieve the discomfort of the patient and prevent stiffness of the muscles due to limited mobilisation. It involves a range of treatments including exercises and massages. An occupational therapist can also identify and evaluate any limitations Guillain-Barre Syndrome may cause in a person’s daily routine, suggesting adaptions and skills that can be put into practice to reduce this impact.

NRC Medical Experts believe that individuals living with the debilitating complications of GBS should be offered neurorehabilitation to reduce the impact on their quality of life.

Our specialists are experienced in assessment by thorough evaluation, examination, producing court reports and medico-legal witness testimony in legal issues concerning Guillain–Barré syndrome.

Meet our experts specialising in Guillain–Barré syndrome and contact us to arrange a complimentary pre-instruction conversation today.

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