Guillain-Barre Syndrome is an autoimmune disorder where the body’s immune system attacks itself.
Like any child her age, 11-year-old Rachana was active, performing well in school and sports. And when she developed cold and cough, nobody realised that it was the beginning of a serious health problem. In a few days, she developed weakness in her arms and legs, and poor balance. As a result, she could not sit or stand.
After a neurological examination and a nerve-conduction study, the diagnosis was that she had Polyneuritis Cranialis, a variant of Guillain-Barre Syndrome (GBS). After spending over a fortnight in hospital, she has almost recovered. This disease strikes one in 1,00,000 children globally.
“Rachana was suffering from cold and cough for over a week. Then she started complaining of headache. This was followed by weakness and unsteady gait and vomiting. When we consulted a doctor in Mandya, he took over a week to diagnose the problem,” said Ravi Kumar, Rachana’s father. Ravi brought his daughter to Bangalore and admitted her to Manipal Hospital.
During admission to the hospital, she was drowsy, but responded to verbal instructions. Other symptoms she displayed were her inability to shut her eyes tight or blow her cheeks. She had a nasal speech and difficulty in swallowing her saliva. “There was weakness in her arms and legs with poor balance. She could not sit or stand,” said Dr Bidisha Banerjee, consultant, paediatric neurologist, Manipal Hospital.
“After a neurological examination and a nerve-conduction study, the diagnosis was that she had Polyneuritis Cranialis. She was treated with intravenous gamma globulin (IVIG), physiotherapy and tube-feeding until her swallowing recovered,” she added.
On the 14th day after the onset of her symptoms, she could swallow, close her eyes, sit up unsupported and speak in a normal voice, said Ravi. She was subsequently discharged and on a follow-up visit after one month, she had no tell-tale signs of her disease.
GBS occurs in one out of 1,00,000 children. And Polyneuritis Cranialis manifests in only among 10% of the GBS cases.
Why does this happen? GBS is an autoimmune disorder (the body’s immune system attacks itself). When we develop an infection, the body develops antibodies to fight foreign antigens (such as infectious agents). However, the foreign antigens imitate the body’s antibodies and the body’s immune system attacks itself, said Dr Banerjee. The nerve-sheet or myelin gets affected and it takes around four to six weeks for it to recover. In Rachana’s case, she showed improvement within the first 15 days after getting infected. While she was hospitalised by March-end, her follow-up check indicated total recovery.
GBS can occur in adults too. Seventy-one-year-old M Aravind continues to work, drive and spend time with his grandchildren. But three years ago, things were different. “I had cold and cough and was on antibiotics. I went to attend a wedding in Chennai. My hands and legs began to itch. Back in Bangalore, I had bad headache and nausea,” said Aravind. His condition worsened. He was unable to close his eyes, hold water in his mouth or move his right leg. Soon, he was admitted to the ICU in Manipal Hospital.
“After a few days, a neurologist suspected GBS and I got treatment. It took another 20 days before I got discharged,” he said. With physiotherapy, it took three months for Aravind to bounce back to life.
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