Guillain-Barre Syndrome (GBS) is an inflammatory process that involves the attack of the peripheral nerves (nerves exiting from the spinal cord and supplying the body). GBS involves both motor and sensory nerve fibres (including pain). The inflammation is an autoimmune process - the body's own defence system attacks the nerves. 

Why does this happen? The reason for the immune system malfunction is unknown, however, it is typically triggered by an external stressor that stimulates an immune reaction. Most commonly, this is a viral illness. Rarely, it can be caused by a vaccination, or something stressful to the body like a surgery.  The immune system usually begins to attack the nerves a few days to a few weeks after such a stressor. 

Symptoms begin distally and moves proximally - medical jargon meaning they begin in the hands and feet and moves up the limbs towards the trunk. The sensory nerves are often first affected, meaning the patient will report symptoms of numbness, tingling and/or nerve pain. This will eventually progress to weakness as the motor fibres are taken out. 

How are the nerves damaged? The inflammation leads to 'demyelination', whereby the myelin sheath produced by Schwann cells is damaged. Myelin is like the insulation around a wire (the nerve) - without it, the electrical messaging system cannot conduct as efficiently.

GBS has a wide range of severity and outcomes. A helpful tool in preventing serious, chronic disability is early detection and treatment with intravenous Immunoglobulins (IVIG) - they scour through the blood and mop up those traitorous immune cells. Plasmapheresis is another method, similar to dialysis in theory - it filters the blood and removes autoantibodies. 

GBS must be treated very carefully, disease progression can occur to the point of affecting the muscles involved in breathing - which may require ventilatory support. Despite this aid, GBS can lead to death in a small minority.

A diagnosis is made by a neurologist, with the aid of typical neurological tests - including MRI imaging, cerebrospinal fluid testing and nerve conduction studies. 

Oddly, GBS can also affect the nerves of the autonomic system. The autonomic nervous system helps us regulate our heart rate and blood pressure, dependent on our body's need at that time (eg. physical exertion). The result - GBS patients can experience wild swinging of their vitals, including core body temperature. Treatment involves attempting to combat the variations with medication to stabilise the patient. 

GBS is certainly a chaotic syndrome. It receives its name from the discoverers of its cerebrospinal fluid profile (increased protein) - Georges Guillain and Jean Alexandre Barré. They found this CSF abnormality in soldiers diagnosed with the condition in 1916. A chaotic syndrome named in a chaotic time.