Experts in Bengal shed light on causes, risks, and treatment of Guillain-Barré Syndrome

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With rising cases of Guillain-Barré syndrome (GBS) cases in West Bengal, and over three GBS-related deaths, medical experts from the State shed light on the threat of the disease, its probable causes, the impacts, precautions, and treatment.

Though the number of cases or deaths related to GBS has not been confirmed by the West Bengal government’s Health department, three suspected GBS-related deaths have been reported from the State till now. Doctors suggest that there is no major clustering and surge in the cases as caution has been maintained, but there was no cause for panic.

According to inputs shared by an insider source from the Health department with The Hindu, they said the State and its hospitals, both private and public are well-equipped to treat GBS cases if it increases with time. “All district hospitals also have lumber puncture testing options available. There is an acceptable clinical guideline that doctors follow which outlines which patients need what type of care,” they added.

But the government is preparing a standard operating procedure (SOP) to help sub-divisional, district medical facilities to pick up on early symptoms and offer care. Bangur Institute of Neurosciences neurology professor Biman Kanti Ray, who has helped draft the SOP, told The Hindu: “The SOP includes warning signs and symptoms, how to diagnose, offering care, type of care, and when a patient should be referred to a specialised hospital in case of fatal situations.”

Arindam Ghosh, a neurology consultant with Narayana Hospital in Howrah, said that GBS is a neurological and immunological disorder where an invading organism enters the human body, identifies our defensive cells, and kills them. Nerve cells also get affected in the process. “Usually, there is an antecedent symptom two to four weeks before the major symptoms start. That can be a common cough and cold, diarrheal episode. In the later stage, a person’s lower limbs start to feel rubbery and there is a tingling and numbness sensation. Then, it affects the trunk muscles and neck area and oral muscles which affects physical movement or even affect swallowing,” he said.

The doctor added that this disease has been known for over 100 years and maintaining basic hygiene apart from cooking one’s food properly are the basic precautions against catching the infection. Dr. Ghosh said that none of these symptoms can kill a person till the time the respiratory muscles are not involved. If that happens, then a person can go into respiratory paralysis which can become life threatening.

Such patients need critical care and may need medical support to help with their breathing.

Another reason why GBS can become fatal is when the autonomic nervous system gets affected or a patient who is not able to swallow properly can sometimes choke on their own saliva if not monitored closely.

“Some patients may notice improvements within weeks, while others may take months to regain strength and mobility. Early diagnosis and immediate medical care are important because they can go a long way in determining the course of recovery. Intravenous immunoglobulin therapy or plasmapheresis, in addition to supportive care, have been found to improve the outcomes of recovery,” said Arabinda Mukherjee, neurologist at Calcutta Medical Research Institute. He also added that it is crucial for affected patients to undergo rehabilitation programmes like physiotherapy, which can help better their condition.

Most patients are expected to recover from the disease completely, some can have long lasting effects, which can cause muscle weakness for a prolonged period of time.