All about Guillain-Barré syndrome: Asger, a retired physician, suffered from polyradiculitis

Debut: Night between 21-22 August 1998, with intense pain across the upper back. A few days before this, tingling and abnormal sensations in my hands and feet.

Tønder hospital, Denmark: 22-23 August. No diagnosis.
Moved to Holstebro hospital, department N2: 23 August-4 September 1998.
Diagnosis: Guillain-Barré polyneuropathy.
Treatment: Physiotherapy. During my stay, increasingly abnormal sensations in my hands and feet, and decreased sense of touch. Decreased deep reflexes (knee- and achilles tendons), gradual loss of the proprioceptive sense (the sense that tells us where our limbs are, without having to look) and loss of muscular strength in the legs, less so in the arms. Walking ability shows ataxia (twitching), and later on, signs of strongly reduced muscular strength.

Deterioration continued after I was discharged, despite the physiotherapy. After 7 weeks, my strength was reduced so much that I could barely drag myself around using a walker.

Because of a tendency to arrythmia (irregular heartbeat), I was prescribed anticoagulatory medication that resulted in bleeding in the intestine.
Acute hospitalisation 5 September 1998 - given blood transfusions. The irregular heart rhythm is now being treated with Verapamil mgv.

Department N2: 15-18 september 1998. Admitted and the same diagnosis made. Despite further deterioration in neurological condition, no treatment apart from physiotherapy. Discharged.

Department N2: 9-30 october 1998. Admitted and the same diagnosis made. Deterioration. My journal now reads:
"Walks hesitantly, unsteadily, using a walker, almost dragging his legs. Hypoton (limp) in both legs, cannot lift his legs. Weakened hip bending ability, knee flex and severe weakening of the dorsal flex of the feet (ability to bend the feet upward)".
Plasmapheresis and physiotherapy prescribed.

Then: "- has had 6 plasmapheresis treatments and feels himself that his walking ability has improved considerably. Can now walk at a reasonable speed, using a walker - but his walk is still unsteady, due to instability over the knees".

In the beginning of december 1998, beginning loss of strength in the legs, measurable in the biceps femoris (the muscle that bends the knee, sited on the back of the thigh). Therefore given a series of plasmapheresis on an outpatient basis on 8 & 21 december, and 12 january 1999. Again new progress registered.

Since being discharged on 30 october, 1998, I have been going to intensive physiotheraphy three times a week. My physiotherapist is Flemming Angel at Hvidbjerg hospital. Strength and muscle volume across my hips and thighs are somewhat back to normal again. I can walk around indoors, without having to use a walking stick. Can walk about a kilometer (½ mile) using a walking stick, at a relaxed pace.

The physiotherapist noted my status 28 august 1999: "Slightly reduced walking speed, normal stride length, good arm swing and rotation. Reduced foot movement, the heel is planted first but the forefoot slaps down during the rest of the stepping movement. Good balance while walking on a firm flat surface, but unsteady in rolling terrain, although good at regaining equilibrium. Bilateral muscle strength good in the gluteal and thigh musculature. Reduced bilateral strength of the hamstrings, muscles of the lower legs and specially the feet. Reduced thermic and tactile sense in the "sock" area, i.e. the feet".

From March 1999, I have been going to intensive physiotherapy and have been lifting weights three times a week at the Center clinic in Struer, where I have a very energetic and inspiring physiotherapist.
I now have quite good muscular function in both my arms and legs. I can go on quite long walks at a relaxed pace, and cycle a distance of 20 km. I've been taking care of my garden on my own the entire summer. During the last month, I have been able to jog short distances, but the front of my foot still droops when I run, making it difficult. This does not happen when I walk though.
I still have sensory disturbances in my feet and hands.

I am quite optimistic about the progress I am making and am fighting to get better. From september I will begin working a couple of days every week.

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