Guillain-Barré syndrome secondary prevention


 * Associate Editors-In-Chief: Priyamvada Singh, MBBS [mailto:psingh@perfuse.org]

Overview
Guillain-Barré syndrome (GBS) is an acute, autoimmune, polyradiculoneuropathy affecting the peripheral nervous system, usually triggered by an acute infectious process. Following the acute phase, the patient may also need rehabilitation to regain lost functions. This treatment will focus on improving ADL (activities of daily living) functions such as brushing teeth, washing and getting dressed. Depending on the local structuring on health care, there will be established a team of different therapists and nurses according to patient needs. An occupational therapist can offer equipment (such as wheel chair and cutlery) to help the patient achieve ADL independence. A physiotherapist would plan a progressive training programme, and guide the patient to correct, functional movement, avoiding harmful compensations which might have a negative effect in the long run. There would also be a doctor, nurse and perhaps a speech trainer involved, depending on the needs of the patient. This team contribute with their knowledge to guide the patient towards his or her goals, and it is important that all goals set by the separate team members are relevant for the patient's own priorities. After rehabilitation the patient should be able to function in his or her own home and attend necessary training as needed.

Secondary prevention
A fundamental part of hospital treatment should fall on the family. As hospitals reduce healthcare it becomes impossible to care for patients around the clock. Patients that reach total paralysis are unable to signal or call for help and this is where family care becomes so important. Family members provide care and support that patients desperately need and medical staff sometimes don't understand or are unable to provide. Due to inactivity the body loses tone and flexibility. It's suggested that learning Range of Motion from medical staff and using stretches and keeping the joints pliable will aid the patient to recover sooner than letting them lay in a vegetative position. This also helps with circulation and the onset of bedsores. Bedsore prevention mattresses provide comfort to the patient if the family is unable to maintain 24 hour care. This is important because hospital recovery from Guillain-Barre can last from weeks to months.