DRHOOK- Guillain-Barre: No cure yet for scary paralysis

the handsome doctor John Hong

Stage fright can paralyze the whole body. Remember Shirley Jones in The Partridge Family when her character had to sing for the first time? She got lockjaw and couldn't move, couldn't breathe!

Stage frights isn't something I understand because I love to be on stage! We just had another family cruise, and guess who came in second place in the karaoke finals– again? (Always a bridesmaid but never a bride.)

What happens if your body suddenly becomes paralyzed?

Guillain-Barre Syndrome (GBS) is something you probably see on those commercials for nasty lawyers hoping to sue vaccine makers. GBS, however, usually follows some viral illness or an accident: it's an inflammatory demyelinating polyneuropathy. That means the nerve coating gets stripped, leaving the nerves pretty useless, which leads to weakness. 

It takes up to a week for a GBS sufferer to see the doctor, usually because the patient can't walk well. The weakness starts furthest from the head and works its way up. However, about 10 percent of the time the weakness starts in the arms and face.

The weakness is bilateral, meaning on both sides. Both feet, both legs, both hands, both arms eventually become paralyzed equally and at the same time. 

Parathesias can accompany the weakness, which means a feeling of tingling, or "pins-and-needles," or numbness like when your foot is asleep. Feeling is still there, although it might be distorted.

You know what happens when the doctor hits below your knee with the little rubber hammer and your leg kicks up? This reflex almost disappears with GBS. 

In over half of people with the syndrome, the face and throat become weak. So, beside the fact it's hard to swallow their medical condition, it might also become hard to swallow food and liquids. If the face is paralyzed, speaking and chewing are out of the question. In 15 percent of cases, the eyeballs become paralyzed. 

The patient has to be watched very carefully in the hospital because 10-30 percent of victims will stop breathing. If breathing gets too compromised, the patient is put on a mechanical ventilator.

Miller Fisher Syndrome is a type of GBS that accounts for five percent of US cases and 25 percent of cases in Japan. In Miller Fisher, the eyeballs don't move and reflexes are gone, but there's no paralysis. Instead there is ataxia, which means shaky movements and walking. Sometimes hearing loss occurs, and even vision loss. If vocal cord paralysis occurs, speech is impossible. 

Dysautonomia occurs in 70 percent of cases, which leads to systemic problems such as fast and/or slow heart rate. Blood pressure can go up and down like a yo-yo. If the bowels stop, gas builds up and bowel movements end. (Ugh!) Bladder retention means voluntary peeing stops. And you can't say, "Don't sweat it"– not only because GBS is terrible and possibly deadly, but also because perspiration can stop. 

The symptoms progress on average for two weeks, but by week four after the initial symptoms, it stops getting worse. In majority of cases, people recover, although quite a few folks will have life-long residual weakness. 

Diagnosis is confirmed on cerebral spinal fluid analysis; a lumbar puncture is needed to draw out the fluid. (That is where the doc sticks a needle in the lower back. It sounds scarier than it actually is.) 

Stage fright isn't such a bad thing when you compare it to GBS! I just hope someone finds a cure soon for this terrible syndrome. 


Dr. Hook cracks a joke or two, but he's a renowned physician with an interesting website, drjohnhong.com. Email him with your questions.