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Progressive phase
Plateau phase
Recovery phase
Further reading
Patients suffering from Guilain-Barré
syndrome usually experience just one attack that generally
lasts for a few weeks, after which the attack stops spontaneously.
The rest of the time is spent recovering from the attack.
The course of Guillain-Barré syndrome (GBS) can be split
up into 3 phases.
Progressive phase
This phase lasts typically 2-3 weeks, measured from the
observation of the first symptom until no further deterioration
occurs. This point is known as the 'nadir'.
It is in this phase that GBS patients develop the pain, progressive
weakening and sensory abnormalities that characterise this
disease. The symptoms increase in severity and extent in a
very unpredictable way, depending on how badly affected the
patient is. Cases of mild GBS reach a clinical nadir in a
similar time to those with more severe disease.
The difference in severity of the syndrome seems to be determined
in this phase. Early treatment shortens the transition to
the recovery phase, and reduces the risk of permanent physical
damage. Treatments focus both on reducing pain and symptoms.
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Plateau phase
The infection phase is followed by a stable plateau phase,
where neither worsening nor improvement occurs. The attack
has ceased, but the degree of weakness remains unchanged until
the recovery phase begins.
In this phase, emphasis is laid on supporting the functions
that are weakened or lost. The patient's blood pressure, cardiac
rhythm, respiration, nutritional and fluid status and general
status are monitored carefully. Immunotherapy treatment begun
in the progressive phase continues.
The patient is generally very weak and requires lots of rest,
skillful care and physiotherapy. GBS patients generally experience
a great deal of pain from inflamed nerves, stiff muscles and
joints. This pain disappears when recovery begins.
The duration of the phase cannot be predicted with any accuracy.
It may be a few days or several months. Some patients inexplicably
move directly from the infection phase to the recovery phase,
while others remain in the plateau phase for several months,
before the recovery phase begins.
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Recovery Phase
Finally, the long-awaited recovery phase begins, with
spontaneous improvement and recovery. The immune system stops
producing the antibodies that destroy myelin, and the symptoms
gradually disappear. Nerve healing commences.
Treatment during this phase focuses on physiotherapy, to
build up the patient's muscles, regain muscle movement and
strength, and teach the patient to use the muscles optimally.
Pain is still experienced, although it now stems from the
regenerating nerve cells and physiotherapy.
The duration of this phase cannot be predicted. Recovery
is individual, and may be achieved in a few weeks or after
several years. Relapses may occur. Many patients are able
to begin working again after 3-6 months, while others display
slight symptoms for a long time after recovery. The degree
of recovery depends on the severity of the nerve damage that
occurred in the infection phase.
Check out 'Case Histories' for real-life stories on how others
have experienced GBS, and the advice they pass on to fellow
patients.
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Further reading
- Case histories
English and foreign-language
case histories that inspire and support patients and their
families. Patients describe the course of their illness, how
they handled the syndrome, how their families worked together
with health personnel to ensure an optimal treatment. They
also describe recovery and life post-GBS.
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