What is GBS?

During the early part of the acute hospital stay, physical therapy is usually started even if the weakness is negligible. In fact, this is a most important part of the patient's care. Such treatment may include movement by a therapist of limbs to prevent abnormal bending of joints (contractures) as well as bedsores. Special attention is usually given to the knee, ankle, hip, shoulder, elbow and wrist joints. A footboard or other device may be used to prevent foot drop.

Pain of joints and muscles can be treated with pain medications (analgesics), such as aspirin, or stronger prescription agents, if needed. Muscle spasms can be treated with relaxants, such as diazepam (Valium®).

During the syndrome's earliest stages, and even through its entire course, the patient may experience difficulty and frustration from abnormal sensations. The frustration arises because the sensations are truly felt by the patient and can be quite severe or annoying, but have no physical correlation outside the body (eg. the feeling of pain, but without injury) and may be difficult to control.

Furthermore, they can be quite difficult to demonstrate, measure, or otherwise document. One example is the sense of vibration while lying perfectly still in bed, a phenomenon experienced by the author. Another example is the sense of excruciating pain, so severe that analgesic medications don't give relief and potentially addicting narcotics may be considered. The treating physician may be hard pressed to justify use of such drugs for a problem he can't prove exists. Other sensation abnormalities may be quite subtle and difficult for even the patient to describe. The author, for example, would cough, choke and aspirate the ice cold water used to take medications. Room temperature water was easily tolerated. This problem probably reflected, in part, decreased sensation by cold receptors in the throat.

Most of the various sensation problems usually resolve with time. Particularly bothersome sensations may sometimes respond to treatment with such drugs as phenytion (Dilantin®) or carbamazeprine (Tegretol®). As these agents can have significant side effects, the decision to use them should take into consideration the potential benefits versus risks. Some-times, pain can be relieved by a transcutaneous electric nerve stimulator (TENS) unit, a portable, battery powered device that supplies electric current to the skin and underlying nerves. It is important to realise that the complications and therefore treatments of Guillain-Barré syndrome are not predictable. For the most part, treatments are highly individualised.