CIDPUSA.org Autoimmune diseases

Guillain-Barre (ghee yan-bah ray) (GBS), Chronic Inflammatory Demyelinating Polyradiculoneuropathy (C.I.P.D.), Miller Fisher and other syndromes are rare and can make a person's very weak very quickly. These syndromes, are disorders that consists of weakness and  paralysis of many parts of the body, along with abnormal sensations. The illness presents in several ways, at times making the diagnosis difficult in the early stages. The specific cause is a autoimmune reaction. Research indicates that, the nerves of the person who has Guillain-Barre or a related syndrome, are attacked by the body's defense system against disease (antibodies and white blood cells). As a result of this attack, the nerve insulation (myelin) and sometimes even the covered conducting part of the nerve (axon) is damaged. This attack delays & changes of the nerve "messages", between the sender (the brain) and receiver (muscle). The abnormal sensations and weakness quickly follow. The affected individual is crippled.

What is Miller Fisher Syndrome:

In MFS syndrome the patient presents with eye movement disorders, weakness . Usually the person has no eye movements. Treatment of Miller Fisher is the same as for GBS or CIDP.

LANDRY'S ASCENDING PARALYSIS (1859)

The sensory and motor systems may be equally affected. However the main problem is usually a motor disorder characterized by a gradual diminution of muscular strength with flaccid limbs and without contractures, convulsions or reflex movements of any kind. In almost all cases micturition and defecation remain normal. One does not observe any symptoms referable to the central nervous system, spinal pain or tenderness, headache or delirium.

The intellectual faculties are preserved until the end. The onset of the paralysis can be preceded by a general feeling of weakness, pins and needles and even slight cramps. Alternatively the illness may begin suddenly and end unexpectedly. In both cases the weakness spreads rapidly from the lower to the upper parts of the body with a universal tendency to become generalized.

The first symptoms always affect the extremities of the limbs and the lower limbs particularly. When the whole body becomes affected the order of progression is more or less constant: (1) toe and foot muscles, then the hamstrings and glutei, and finally the anterior and adductor muscles of the thigh; (2) finger and hand, arm and then shoulder muscles; (3) trunk muscles; (4) respiratory muscles, tongue, pharynx, esophagus, etc. The paralysis then becomes generalized but more severe in the distal parts of the extremities. The progression can be more or less rapid. It was eight days in one and fifteen days in another case which I believe can be classified as acute. More often it is scarcely two or three days and sometimes only a few hours.

When the paralysis reaches its maximum intensity the danger of asphyxia is always imminent. However in eight out of ten cases death was avoided either by skilful professional intervention or a spontaneous remission of this phase of the illness. In two cases death occurred at this stage . . . When the paralysis recedes it demonstrates the reverse of the phenomenon which signaled its development. The upper parts of the body, the last to be affected, are the first to recover their mobility which then returns from above downwards.

Jean Baptiste Octave Landry de Thezillat (1826-1865)

A-42-year old man presented with progressive difficulty in walking and climbing stairs for past 2 days, weak handgrip and inability to raise arms above shoulder level for the past 1 day. He developed intermittent choking on swallowing liquids since the morning of the day of admission. We discuss here Guillain Barre Syndrome as an acute immune mediated polyneuropathy.

continued to GBS case report