CIDP (CHRONIC INFLAMMATORY DEMYELINATING POLY [RADICULO]
NEUROPATHY)
What Is GBS?
GBS is short for ‘Guillain-Barrê Syndrome’
(pronounced Ghee-lan Bar-ray). It is an acute disease of
the peripheral nervous system in which the nerves in the
arms and legs become inflamed and stop working. This causes
sudden weakness leading to limb paralysis, and a loss of
sensation, sometimes with pain.
What is CIDP?
Some patients have a similar but longer-lasting illness
called CIDP (chronic inflammatory demyelinating poly[radiculo]neuropathy).
CIDP, once known as ‘chronic GBS’, is now usually
regarded as a related condition.
Who can get GBS and CIDP?
Anyone: young or old, male or female. The illnesses are
neither hereditary nor contagious. GBS affects about l50
people every year in the United Kingdom; the incidence of
CIDP is perhaps one tenth that of GBS.
What causes GBS/CIDP?
This is a matter of much research. About sixty percent of
patients suffer from a throat or intestinal infection, influenza
or stress symptoms in the previous two weeks. These infections
trigger an incorrect response in the immune system which
attacks the nerves.
What are the symptoms?
First symptoms are usually tingling and numbness in the
fingers and toes with progressive weakness in the arms and
legs during the next few days. In the mildest of cases,
the weakness may arrest and cause only moderate
difficulty in walking, requiring sticks, crutches or a walking
frame.
In some cases the weakness progresses and leads to complete
paralysis of the legs, the arms may also be affected. In
a quarter of cases the paralysis progresses up the chest
and the patient is unable to breathe on his or her own and
needs to rely on a mechanical breathing machine (ventilator).
The throat and face may be affected making swallowing impossible
and so the patient needs to be fed tube up the nose or directly
into the stomach.
For CDP patients the illness follows a longer course but
respiratory failure is highly unlikely.
How are GBS and CIDP diagnosed?
From the history and clinical examination. This is difficult
because the symptoms may be confused with those of other
conditions.
Two confrmatory tests may be helpful and are performed in
most cases:
• lumbar puncture — under a local anaesthetic,
a needle is inserted between
the lower back bones and a small amount of spinal fluid
is drawn off for
analysis and
• elecromyogram (EMG) — an electrical recording
of nerve conduction and
muscle activity.
What is the treatment tor GBS?
GBS improves spontaneously. However certain factors can
assist recovery:
• good nursing and medical/intensive care;
• physiotherapy and hydrotherapy. therapies that relsove
discomfort and
prevent stiffness;
• plasmapheresis — the exchange of blood plasma
generally reduces the
duration of the disease in severe cases if carried out in
the first few days;
• immunoglobin -- the infusion of immunoglobin proves
successful with
similar results to plasmapheresis and
• counselling to reassure the patient and encourage
the patient towards
recovery.
What is the treatment for CIDP?
Like GBS, CIDP can improve without treatment. However, recovery
may be very slow and the illnesss can either get progressively
better or worse, or can follow a relapsing/remitting course.
Most patients are given treatment in the forms of plasmapheresis,
immunoglobin or corticosteroids Other drugs may be used
in difficult cases.
Do all patients recover?
Most patients (80%) make a total recovery but many spend
three months or more in hospital and take a year to recover.
Some patients do not recover completely and have residual
weakness, numbness and occasional pain. A small number are
unable to resume their normal occupation. Modern intensive
care makes death from GBS a rare occurrence but is does
occur in around 5% of cases, more commonly in the elderly.
Death resulting from CIDP is highly unlikely. Uncommonly,
GBS returns a second time or may turn into CIDP
What more can be done to help?
•More research to help doctors diagnose and treat
GBS/ClDP~
•more information for medical personnel and lay people
•improved counselling and support facilities for patients
and their families.
Where can I get more Information?
The GBS Support Group publishes a booklet: Guillain-Barre
Syndrome a short guide for relatives and friends
Can I talk to someone about GBS now?
Yes. Call the GBS Helpline on 0800 374 803
Is it possible to arrange a hospital visit by a
recovered patient?
Yes. ring the GBS Helpline.
Information Courtesy of:
GBS Support Group of the UK
LCC Offices, Eastgate, Sleaford, Lincolnshire. NG34 7EB
Tel/Fax: 01529 304615.
Email: admin@gbs.org.uk
Free Helpline 0800 374803
For Further information visit the website
www.gbs.org.uk
