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Acute inflammatory demyelinating polyneuropathy (AIDP)

Acute inflammatory demyelinating polyneuropathy (AIDP)



Overview

Acute inflammatory demyelinating polyneuropathy (AIDP), also known as polyradiculoneuropathy, is the most common form of Guillain-Barré Syndrome (GBS). It's an autoimmune disorder where the body's immune system attacks the peripheral nerves, leading to inflammation and damage to the myelin sheath. This damage results in the rapid onset of muscle weakness and sensory loss in the limbs

Guillain-Barré syndrome (GBS) is also called acute inflammatory demyelinating polyradiculoneuropathy (AIDP). It's a neurological disorder in which the body's immune system attacks the peripheral nervous system. This is the part of the nervous system outside the brain and spinal cord. 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.

GBS is rare, affecting about 3,000 people in the U.S. It can affect people at any age and both men and women equally. GBS often develops after a respiratory or gastrointestinal viral infection.

Symptoms

Tingling and Numbness: A prickly or "pins and needles" feeling (paranesthesia) often starts in the fingers and toes before any muscle weakness appears.

Muscle Weakness: The weakness usually starts in the legs and spreads upward (ascending muscle paralysis) to the arms. It happens on both sides of the body at the same time.

Loss of Reflexes: Doctors may check reflexes (like the knee-jerk reflex), and in most people with GBS, these reflexes are missing.

Pain: Some people feel pain in their limbs or back.

Breathing Problems: In more severe cases, GBS can make it hard to breathe.

Facial and Speech Issues: In rare cases, individuals may experience trouble moving their face, swallowing, or speaking.

Progression: Symptoms get worse over a period of 12 hours to 4 weeks, then usually stop getting worse and stay stable before improving (clinical plateau).

When triggered by an infection, clinical symptoms of GBS usually appear within 3 days to 6 weeks of the infection.

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.

Diagnosis

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.

To diagnose GBS, you may have the following tests:

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.

Treatment 

There is no known cure for GBS. Without treatment, GBS may get better on its own. But treatment may improve chances of a faster recovery. Treatments, such as plasmapheresis or immunoglobulin, suppress the immune system and reduce inflammation caused by the immune system’s response to the disease. Either of these treatments can reduce the amount of time it takes for you to walk or breathe on your own again.

Plasmapheresis is a procedure that removes the plasma (liquid part of the blood) and replaces it with other fluids. Antibodies are also removed with the plasma, which is thought to help reduce the symptoms of the disease.

Immunoglobulin is a blood product that helps to decrease the immune system’s attack on the nervous system.

Supportive treatment is also given to prevent breathing problems and relieve symptoms. You will need to stay in the hospital for treatment. Medicines are used to control pain and other conditions that may be present. Physical therapy can increase muscle flexibility and strength. Some people get better in a day or two. Others may take much longer to recover.

Through research, new treatments for GBS are continually being identified.

Type of Doctor Department : A neurologist


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