GB and ALS

Guillain-Barré Syndrome

Overview of Guillain-Barré Syndrome

  • Rare disease affecting the body's immune system.

  • The immune system attacks the peripheral nervous system (PNS).

  • This condition can eventually cause paralysis.

Cause of Guillain-Barré Syndrome

  • The exact cause of Guillain-Barré syndrome is unknown.

  • Classified as an autoimmune disease.

  • It is believed to be triggered by an infection.

    • There is speculation about vaccinations potentially serving as a trigger.

Symptoms and Signs (S/S)

  • In addition to muscle weakness, patients may experience:

    • Difficulty with eye muscles and vision.

    • Difficulty swallowing, speaking, or chewing.

    • Pricking or pins-and-needles sensations in the hands and feet.

    • Severe pain, particularly at night.

    • Coordination problems and unsteadiness.

    • Abnormal heart rate or blood pressure.

    • Problems with digestion and/or bladder control.

Pathophysiology

  • Normal nerve structure contrasted with affected nerve due to Guillain-Barré syndrome:

    • Exposed fibers and damaged myelin sheath which lead to impaired nerve function.

Prognosis

  • Recovery outcomes:

    • Approximately 70% of patients recover fully.

    • Around 30% experience slow or incomplete recovery.

    • 15% of patients may have long-term weakness, necessitating assistive devices (e.g., wheelchair, walker, ankle support orthoses).

    • Mortality rate in this syndrome is about 3-5% of cases, often due to complications such as:

    • Sepsis.

    • Acute Respiratory Distress Syndrome (ARDS).

    • Pneumonia.

    • Pulmonary Embolism (PE).

Treatment Options

  • Treatment approaches include:

    • Medications and medical interventions aimed at addressing immediate paralysis.

    • Physical therapy to aid in recovery and rehabilitation.

    • Occupational therapy to support the patient’s daily living activities.

Amyotrophic Lateral Sclerosis (ALS)

Overview of ALS

  • Also known as Lou Gehrig’s Disease.

  • It is classified as a progressive neurodegenerative disease affecting nerve cells in the brain and spinal cord.

  • The term "amyotrophic" can be broken down etymologically:

    • "A" indicates absence.

    • "Myo" refers to muscle.

    • "Trophic" implies nourishment.

    • "Lateral" indicates the specific area of the spinal cord primarily affected.

    • "Sclerosis" refers to scarring.

Pathophysiology of ALS

  • ALS leads to degeneration of motor neurons, ultimately resulting in their death.

  • Motor neurons are crucial as they stimulate muscle activity.

  • The disease causes progressive muscular atrophy and weakness.

  • The precise cause of ALS remains unknown.

Definition of ALS

  • ALS can be defined as: Amyotrophic Lateral Sclerosis | noun:

    • A progressive neurodegenerative disease that affects nerve cells in the brain and spinal cord.

  • Healthy motor neurons stimulate muscles to contract, but ALS causes these neurons to die, leading to muscle weakening and eventual paralysis.

Forms of ALS

  • There are two primary forms of ALS:

    • Sporadic ALS:

    • The most common form, accounting for approximately 90% of cases.

    • Familial ALS:

    • This form is hereditary, making up about 10% of all cases.

Onset and Diagnosis

  • The onset of ALS typically occurs between the ages of 40 to 70.

  • Military veterans, especially those who served in the Gulf War, are at twice the risk of developing ALS.

  • Incidence is approximately 20% higher in men compared to women.

Prognosis of ALS

  • Prognostic outcomes include:

    • Around half of all individuals diagnosed with ALS survive at least three years post-diagnosis.

    • Approximately 20% of affected individuals live five years or more.

    • Up to 10% of patients may survive for more than ten years.

Treatment Options for ALS

  • Available treatment approaches consist of:

    • Medications to manage symptoms and progression.

    • Physical therapy to maintain mobility and function.

    • Occupational therapy to assist with daily living skills.

    • Respiratory therapy to support breathing function.

Patient Story

  • Notable case: Hilde Heard, an ALS patient who exemplifies the experiences of those affected by this disease.