Monday, June 20, 2011

Guillain-Barre: An Unknown Taking Down the Healthy Or A Worsening Chronic Infection?

A recent story on ex-quarterback Danny Wuerffel getting Guillain-Barre Sydrome has been in the news recently.

In looking at his symptoms, he came down with a stomach virus, and now is at 50% muscle strength.  Not only is this terrifying, it leads to the thought that none of us is safe. 

For anyone living in a box, Guillain-Barre has historically been associated with vaccinations.  More recent re-analysis of previous studies poo-poo any possible association, but have a look at the 1978 original study:  "that the risk of Guillain-Barré syndrome among individuals receiving immunization against influenza A/New Jersey is 7.3 times the risk among the nonvaccinated."  (Adv Neurol. 1978;19:249-60.)

It is a miniscule risk, and shouldn't deter anyone from vaccination for that reason alone, but the association makes sense if one thinks about the fact that the virus is often simply weakened, not entirely dead.  In a very few susceptible individuals it may spark an autoimmune cascade. 

The truth is that we've got a pretty good idea of what is causing this cascade.  It may vary from individual to individual, but the majority have antibodies that correspond to both an infectious agent and their own neural tissue.  A recent study (J Neurol. 2011 Apr 24. ) found that a quarter of all patients had been infected by Campylobacter jejuni.  Another recent study in China concludes:  "Our results suggest that the antecedent C. jejuni infection triggered this GBS outbreak in China." (Foodborne Pathog Dis. 2010 Aug;7(8):913-9.)  So at least 25% of patients might benefit from antibiotic treatment.  Minocycline has been used to successfully treat an animal model of Guillain-Barre.  (J Cell Mol Med. 2009 Feb;13(2):341-51. )

Currently the standard of care for Guillain-Barre involves intense rehabilitation, IV antibodies, and exchanging plasma for patients.  All of these may be effective only if the body does not continue to generate antibodies from an ongoing infection.

For individuals without medical resources (and that is more and more people here in the U.S.) there are preliminary studies on the effect of ginger, licorice, calendula, and fenugreek.  (Phytother Res. 2010 May;24(5):649-56.)

It shouldn't take a celebrity case to bring the standard of care of this illness in line with the most recent research. 


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