Guillan-Barré syndrome (also known as Landrys paralysis) is a polyneuropathy a condition characterised by widespread dysfunction of the peripheral nerves. The condition is thought to be the result of an auto-immune response, where the immune system over reacts and attacks normal body tissue, following a viral infection or an allergy. The peripheral nerve tissue can be affected in two different ways due to Guillan-Barré syndrome. One way is when the conducting part of the nerve called the nerve cell body and axon is affected. The prognosis in this instance is poor and recovery may be slow or incomplete. The other way the nerve tissue is affected is when the insulating tissue around the nerve the myelin sheath is affected. In this type complete recovery is more likely to occur quickly.
Commonly, the patient experiences changes in sensation in the hands and feet. This can start as tingling and numbness, but quite quickly become painful. This is because the nerves which send sensory signals from the skin to the brain have been affected. Because the nerves which supply the muscles are also affected, muscle weakness and paralysis can occur in the arms, and especially the legs. The muscle weakness and loss of sensation make it difficult for the patient to co-ordinate movements and even walk. Because the nerves which control skin condition can be affected the skin may appear red, swollen and shiny.
Although recovery can be slow, those with Guillan-Barré syndrome will usually make a full recovery. Physiotherapy treatment involves maintaining joint range of movement to prevent contractures and muscle shortening. Sometimes splints may be appropriate to maintain normal joint position. Once the nerve conduction is back to normal a progressive muscle strengthening programme can be started. As the patient begins to recover the physiotherapist can help the patient by facilitating normal movement and encouraging proprioceptive exercises in order to improve co-ordination.
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