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Guillain-Barre Syndrome

Bali News, Denpasar  –  Guillain-Bare Syndrome (GBS), the name may sounds unfamiliar for most of us, but this type of life-threatening illness could attack anyone within hours, days or weeks without many prior symptoms.
Based on National Institute of Neurological Disorders and Strokes, GBS is a disorder in which the body’s immune system attacks part of the peripheral nervous system. It is called a syndrome rather than a disease because no scientist has ever found a specific disease-causing agent involved in triggering the illness.
Medical institutions are still trying to find out why GBS attacked some people and not others, and they have not found the answer until present. What the scientists do know is the body’s immune system begins to attack the body itself, leading to a condition known as an autoimmune disease.
The scary thing about GBS is it could attack anyone unexceptionally, regardless of age, racial background or lifestyle. Usually, GBS occurs a few days or weeks after a patient had symptoms of a respiratory or gastrointestinal viral infection.  From then, the disorder could develop into a life-threatening stage in the matter of hours, days or it may take up to 3 to 4 weeks. In few cases, the syndrome is triggered by surgery or vaccinations, and one study suggests the illness is triggered by the influenza virus or by an immune reaction to the influenza virus.
The first symptom usually felt by GBS patient is the tingling sensation or weakness in the legs. Very often, this weakness and strange sensation spread to the arms and upper body not long after it attacked the legs. The intensity of these symptoms will increase until patient can no longer use their muscles and the body became totally paralyzed. Once it happened, it is considered as a medical emergency situation and patient is often referred to the intensive care unit and put on a respirator to assist with breathing.
Gullain-Barre Syndrome is a rare disease.  The incidence ratio happened in 1 to 2 persons per 100,000 people (Mayoclinic.com, 9-1-2010).  This syndrome can be treated and most patient will recover although some will not gain back their previous normal condition like they used to have before the attack. For example, some patients will lose knee jerks reflex ability.
Until now, there is no exact cure for GBS patients, but some special therapies can lessen the severity of the illness and accelerate the recovery in most patient. The concerning news is, as much as thirty percents of these patients still have the residual weakness effect in their life for up to three years and three percents are reported to have the tingling sensation for some more years after the first initial attack. Further physical therapies are usually needed to make the body motions work normally again. This may include the re-learning activity of chewing, grabbing, walking and other motions needed to take care of one-self.
To confirm if someone is infected by the GBS, a patient must go through a Nerve Conduction Velocity (NCV) test. It is a procedure in which a physician will take small amounts of cerebrospinal fluid that bathes the spinal cord using a spinal tap. Testing this protein-rich fluid in the laboratory is known to give a more accurate result on to the diagnoses.
Like it was mentioned before, GBS can be treated as long as immediate medical action was performed soon after the first symptom occurs. There are number of ways to treat the complication of the disease such as the plasmapheresis and high dose immunoglobulin therapy. Plasmapheresis is used to reduce the severity and duration of the Gullain-Barre episode while high-dose immunoglobulin therapy is used to attack the invading organism. Injecting a small quantity of the protein into the venous area does the procedure. The biggest challenge on doing this treatment is to keep the patient’s body functioning during recovery of the nervous system. Very often, this could involve putting the patient on a respirator, a heart monitor or other machines to assist body function.
Guillain-Barre Syndrome can attack very sudden when people are least expected it to happen. The illness can be very devastating as the recovery could take as little as few weeks and as long as few years with proper therapy. Without proper therapy, someone could die from the virus’ invasion. It is suggested that people immediately consult their GP once they have a heavy breathing or throat problems that followed by a tingling sensation because what we might thought as a usual flu symptom could in fact turned out to be a Guillain-Barre Syndrome.

Family Told of A GBS Patient’s Experience
Wayan Suarsana is a 27 years old security guard working in a private house in Denpasar. He works night shift with approximately of 8 working hours a day. On 28th December 2009 at 06.00 A.M he was supposed to finish the work and get ready to go home as usual. Instead, he was lying next to his motorbike on the garage floor and found by one of the housekeeper who was going to clean the area. At instance, his employer, helped by some other people came and lifted Suarsana’s body into the car. He was still alive with both eyes widely opened.
His employer, Wayan Tunas said Suarsana understood everything other people said but failed to make any motion to react to the many questions asked by others.  All he could do was nodding and mumbling with a very low voice. His foot and hand fingers were all stiffed. Another housekeeper, Ni Luh Dewi explained that Suarsana has told her that he had experienced the tingling sensation on his feet since the last three days before the incident happened. She even gave him a light massage with menthol balm to help ease the tingles. She later explained that Suarsana had a sore throat since the week before, but resisted to see the doctor as he considered it as a usual flu symptom.
Once they arrived at Sanglah Hospital, Suarsana was taken into the emergency unit. After making outside diagnoses and few laboratory tests on his blood, the doctor was positive that Suarsana was infected by Guillain-Barre Syndrome. They suggested the family to proceed with the NCV test to be assured of the sickness, but the family refused to do so as the procedure was going to be very costly. They were afraid they would not be able to bear the cost if such procedure was taken, especially that Suarsana’s sister had gone through such painful procedure when diagnosed with leukemia. She died after spending a couple of months in hospital about a year ago, leaving the family feeling traumatized and lessen believes in medical procedures as a result.
Despite the refusal, a neurologist at Sanglah Hospital suggested for Suarsana to be treated with specific medicine to prevent the virus from spreading into the respiratory area. Once again, Suarsana’s father refused to take the treatment for the medicine price is so high they just cannot afford to buy it.
The neurologist explained that without the medicine, Suarsana’s chance of survival is very low. His condition would decrease in the matter of hours if not given the proper treatment. But without enough money, there was nothing much the family could do to improve his condition.
Suarsana stayed in Sanglah for three nights without any proper treatment before his family decided to bring him home.  On 2nd January 2010, his condition came worst and he was taken back to Kapal Hospital in Tabanan. Until present, Suarsana is still lying paralyzed on his hospital bed, waiting for some people to help him get the proper treatment.-iu-

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