Abstract
Guillain-Barré Syndrome (GBS) is a rare but serious autoimmune disorder in which the body’s immune system mistakenly attacks the peripheral nervous system. Named after French neurologists Georges Guillain and Jean Alexandre Barré, who first described the condition in 1916, GBS can lead to muscle weakness, numbness, and even paralysis. Though its exact cause is unknown, GBS often follows infections and can affect individuals of any age, with a slightly higher prevalence in males.
Keywords
GBS, Numbness, Autoimmune, Infection, Homoeopathy
Introduction
Guillain-Barré Syndrome (GBS) is a heterogeneous group of immune-mediated conditions with an incidence of 1-2/100000/year. GBS is also called acute inflammatory demyelinating polyradiculoneuropathy (AIDP). The onset of GBS can be quite sudden and unexpected. It needs immediate hospitalization. It can develop over a few days. Or it may take up to several weeks with the greatest weakness occurring within the first couple of weeks after symptoms appear.Recently there has been a sudden outbreak of GBS in Maharashtra particularly in Pune. As of now total count of GBS patient is 213 and whereas 11 deaths have been reported of which four are confirmed as GBS. Meanwhile, according to an analysis of the 203 cases , 24 patients each are in the 0-9 and 10-19 age group, 44 in the 20-29 age group, 24 in the 30-39 age group, 27 in the 40-49 age group, 29 in the 50-59 age group, 21 in the 60-69 age group, 6 in the in 70-79 age group and four in the 80-89 age group. The common symptoms of GBS include: Sudden weakness in hands or legs/ paralysis, trouble while walking or weakness with sudden onset and diarrhea, for sustained periods. WHO is supporting health authorities in India’s western state of Maharashtra to respond to suspected and confirmed cases of Guillain-Barré Syndrome (GBS) in the city of Pune. WHO teams are on the ground training the health workforce in conducting ‘active case searches’ in the community living in the affected areas to ensure every suspected case is identified, diagnosed and treated. WHO teams are also conducting field work to validate household visits, monitoring the response conducted by central, state, district/corporation health officials, and participating in the state-, district- and corporation-level reviews.
Types
- Acute inflammatory demyelinating polyradiculoneuropathy
- Miller Fisher Syndrome
- Acute motor axonal Neuropathy
Causes
- It’s not clear why some people get GBS. What is known is that the body’s immune system begins to attack the body itself.
- Normally, the cells of the immune system attack only foreign material and invading organisms. But in GBS, the immune system starts to destroy the myelin sheath that surrounds the axons of many nerve cells, and sometimes, the axons themselves.
- When this occurs, the nerves can’t send signals efficiently, the muscles lose their ability to respond to the commands of the brain, and the brain receives fewer sensory signals from the rest of the body. The result is weakness and an inability to feel heat, pain, and other sensations.
- GBS can occur after a viral infection, surgery, injury, or a reaction to an immunization.
Symptoms
The hallmark of GBS is rapid-onset muscle weakness, beginning in the lower limbs and potentially spreading upward. Common symptoms include:
– Tingling or prickling sensations (paresthesia) in the hands and feet
– Muscle weakness starting in the legs and progressing to the upper body
– Difficulty walking or climbing stairs
– Loss of reflexes
– Severe pain, often described as aching or cramping
– Difficulty with facial movements, including speaking, chewing, or swallowing
– In severe cases, paralysis and respiratory failure
Diagnosis
Diagnosing GBS involves a combination of clinical assessment and diagnostic tests.
The symptoms of GBS vary. It can be difficult to diagnose in its earliest stages.
These symptoms are unique to GBS:
- Symptoms on both sides of the body
- Symptoms appear quickly. They may show up within hours or weeks instead of months.
- Loss of reflexes
- High protein level in cerebrospinal fluid (CSF). CSF is the fluid that surrounds the spinal cord and brain.
Techniques to Diagnose
- Spinal Tap (Lumbar Puncture). A special needle is placed into the lower back, into the spinal canal. This is the area around the spinal cord. The pressure in the spinal canal and brain can then be measured. A small amount of CSF is removed and sent for testing to find out if there is high protein, an infection, or other problems.
- Electrodiagnostic tests, such as electromyography (EMG) and nerve conduction velocity (NCV). These studies are done to evaluate and diagnose disorders of the muscles and motor neurons. Electrodes are inserted into the muscle, or placed on the skin overlying a muscle or muscle group. Electrical activity and muscle response are recorded.
Homoeopathic Management
Homoeopathy has lot to offer in GBS, if we search Homoeopathic medical repertory we will find rubric Gullian berre syndrome with medicines (carcinosin, conium mac., lathyrus sativus, thuja occidentalis) in Clinical chapter
- Conium : Heavy, weary, paralyzed; trembling; bands unsteady; fingers and toes numb. Muscular weakness, especially of lower extremities. The ascending paralysis it produces, ending in death by failure of respiration, shows the ultimate tendency of many symptoms produced in the provings, for which Conium is an excellent remedy, such as difficult gait, trembling, sudden loss of strength while walking, painful stiffness of legs. etc. Such a condition is often found in old age, a time of weakness, languor, local congestions, and sluggishness.
- Lathyrus: Paralytic affections of lower extremities; spastic paralysis; lateral sclerosis. Tips of fingers numb. Tremulous, tottering gait. Excessive rigidity of legs; spastic gait.
- Conium: Knees knock against each other when walking. Cramps in legs worse cold, and cold feet. Cannot extend or cross legs when sitting. Myelitis, with marked spastic symptoms. Rheumatic paralysis. Gluteal muscles and lower limbs emaciated. Legs blue; swollen, if hanging down. Stiffness and lameness of ankles and knees, toes do not leave the floor, heels do not touch the floor, muscles of calves are very tense. The patient sits bent forward, straightens with difficulty.
- Thuja: When walking, limbs feel as if made of wood or glass, and would break easily. The tips of fingers swollen, red, feel red. Muscular twitchings, weakness and trembling. Cracking in joints. Pain in heels and tendo-Achilles. Rapid exhaustion and emaciation.
- Carcinosin: Carcinosin works as a complementary drug when a seemingly well-indicated remedy fails to cure a case or produce a temporary improvement. If there is a family history of cancer, diabetes, syphilis, or any other degenerative disease, carcinosin should be considered. Personal history of recurrent bronchitis, pneumonia, and wooping cough in childhood, as well as a proclivity to contract measles, chicken pox, diphtheria, mumps, and tonsils in childhood, is a sign for carcinosin.
- Causticum : Paralysis of single parts. Dull, tearing pain in hands and arms. Heaviness and weakness. Tearing joints. Unsteadiness of muscles of forearm and hand. Numbness; loss of sensation in hands. Contracted tendons. Weak ankles. Cannot walk without suffering. Rheumatic tearing in limbs; better by warmth, especially heat of bed. Burning in joints. Slow in learning to walk. Unsteady walking and easily falling. Restless legs at night. Cracking and tension in knees; stiffness in hollow of knee. Itching on the dorsum of feet.
- Phosphorus: Ascending sensory and motor paralysis from ends of fingers and toes. Stitches in elbow and shoulder joints. Burning of feet. Weakness and trembling, from every exertion. Can scarcely hold anything with his hands. Tibia inflames and becomes necrosed. Arms and hands become numb. Can lie only on the right side. Post-diphtheritic paralysis, with formication of hands and feet. Joints suddenly give way. Congestion of lungs. Burning pains, heat and oppression of chest. Tightness across chest; great weight on chest. Sharp stitches in chest; respiration quickened, oppressed.
- Gelsemium: Loss of power of muscular control. Cramp in muscles of the forearm. Professional neuroses. Writer’s cramp. Excessive trembling and weakness of all limbs. Hysteric convulsions. Fatigue after slight exercise. Oppression about chest. Centers its action upon the nervous system, causing various degrees of motor paralysis. Paralysis of various groups of muscles about the eyes, throat, chest, larynx, sphincter, extremities, etc.
- Alumina: Arms feel paralyzed. Legs feel asleep, especially when sitting with legs crossed. Staggers on walking. Heels feel numb. Soles tender; on stepping, feel soft and swollen. Pain in shoulder and upper arm. Gnawing beneath finger nails. Brittle nails. Inability to walk, except when eyes are open or in daytime. Spinal degenerations and paralysis of lower limbs. Chest feels constricted
- Lyssinum: Affects principally the nervous system. Spasmodic contraction of respiratory muscles. Weakness of chest ; tired from talking or reading. Weakness in legs when going up stairs. Very soon a sensation of weakness, a kind of flabby lassitude, like days after great exertion, or after a fever or other disease.Great weakness and restlessness, does not know where to turn, would prefer to lie down, but it affects his breathing.
Such weakness that knees tremble at every step, and she feels as if she would fall.
Prognosis
The prognosis for GBS varies among individuals. Most patients begin to recover within weeks of treatment, with 60-80% achieving a full or near-full recovery. However, some may experience lingering symptoms such as weakness, fatigue, or numbness. Approximately 5-10% of cases result in long-term disability, and a small percentage can be fatal due to complications like respiratory failure.
Conclusion
Guillain-Barré Syndrome is a rare but potentially life-threatening condition that requires prompt medical attention. Advances in treatment have significantly improved outcomes, but early recognition remains crucial. Increased awareness and understanding of GBS can help ensure timely intervention and support for those affected by this challenging disorder.
References
Davidson, S. (1995). Davidson’s principles and practice of medicine (I. A. D. Bouchier, C. Haslett, & E. R. Chilvers, Eds.; 17th ed.). Churchill Livingstone.
Express News Service. (2025, February 21). One more GBS case detected, total number at 213. The Indian Express. https://indianexpress.com/article/cities/pune/one-more-gbs-case-detected-total-213-9849261/
Guillain–Barré syndrome. (n.d.). Who.int. Retrieved March 14, 2025, from https://www.who.int/news-room/fact-sheets/detail/guillain-barr%C3%A9-syndrome
HOMOEOPATHIC MATERIA MEDICA – By William BOERICKE. (n.d.). Homeoint.org. Retrieved March 14, 2025, from http://www.homeoint.org/books/boericmm/index.htm
WHO assists response to Guillain-Barré Syndrome in Pune. (n.d.). Who.int. Retrieved March 14, 2025, from https://www.who.int/india/news/feature-stories/detail/who-assists-response-to-guillain-barr–syndrome-in-pune
(N.d.). Hopkinsmedicine.org. Retrieved March 14, 2025, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/guillainbarr-syndrome
SUBMITTED BY
Dr Sushil Kumar Rajbhar
MD Homoeopathic Repertory and Case Taking
Government Homoeopathic Medical College and Hospital
Bhopal {M.P}
GUIDED BY
Dr Neetu Kushwaha
Professor
Government Homoeopathic Medical College and Hospital
Bhopal {M.P}
