You Ask, They Answer
Q
: What are some of the complications posttreatment?
A
: Due to immobility, GBS patients are susceptible to infections, such as lung and urinary tract infection, and bedsore and blood clot formation in the legs that may block the major blood vessels in the lung and heart system( pulmonary embolism). Some may suffer from severe nerve pain, difficulty controlling their bowel and bladder functions, abnormal blood pressure control, irregular heart rhythm, and sudden cardiac arrest.
for recovery. For example, the acute motor sensory axonal neuropathy, or AMSAN, type usually has poorer recovery.
Q
: When should one see a doctor?
A
: GBS is a serious condition that requires immediate attention. See a doctor when there is unexplained numbness and weakness that is persistent, progressive, and rapidly worsens within a short period of time. Some of the GBS symptoms can deteriorate rapidly and are potentially life-threatening.
Seeing a neurologist also helps to exclude other peripheral nerve conditions that mimic GBS.
Q
: What treatments are available for patients?
A
: Treatment in general depends on the severity and timing of the disease. The mildest form of GBS may not need any treatment as it recovers rapidly and fully by itself.
However, the typical GBS patient with disabling symptoms will need treatment that targets the immune system, i. e., intravenous human immunoglobulin or plasmapheresis. These treatments help to hasten the recovery from GBS.
Supportive care includes assisted ventilation in an ICU for severe cases, the treatment and prevention of complications, and intensive rehabilitation to restore the patient’ s baseline functions, e. g., by use of a speech therapist, occupational therapy, and physiotherapy.
These patients may experience severe body weakness and become paralysed for weeks until the condition starts to improve, while some may not recover fully from GBS and therefore suffer from long-term complications such as neuropathic pain, weakness, and numbness of their limbs.
Q
: Can one make a full recovery from GBS?
A
: Yes, it depends on which type of GBS one is having. Prognosis is generally good as 80 percent of patients are able to walk independently by six months. However, some may take 1-2 years for full recovery, while 5-10 percent of patients do not have full recovery and are left with permanent weakness, numbness, pain and gait imbalance, and overall impaired health status and daily function.
Q
: What is your advice on self-care treatment for GBS?
A
: See a doctor when you have the above symptoms. Seek help early as GBS is potentially debilitating, if not life-threatening.
Once diagnosed with GBS, apart from medical treatment, one should engage in intensive rehabilitation aimed at restoring the function of the peripheral nerves as much and as early as possible. This will expedite the return to the patient’ s life before GBS, while minimising complications from immobility. It will be prudent to motivate oneself for rehabilitation as it can be a long journey, ranging from a few months to a few years towards maximal recovery.
Dr Ooi Phaik Yee
Dr Ooi Phaik Yee is a consultant neurologist at Gleneagles Hospital Kuala Lumpur.
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