There is the “maximum reserve” of doctors about the health conditions and the causes that caused the illness of the Russian economist and politician Anatoly Chubais hospitalized in Sardinia. However, according to rumors reported by some media, the symptoms manifested by the former loyalist of Vladimir Putin could be compatible with the Guillain Barré syndrome, which already emerged in the news in the period of Covid for its correlation with reactions to some vaccines.
But let’s see what it is. Guillain Barré syndrome – reports the Istituto Superiore di Sanità – is a rare disease that damages the peripheral nerves that connect the central nervous system (brain and spinal cord) with the rest of the body. It is the most common form of rapidly developing (acute) peripheral neuropathy. The peripheral nervous system is made up of sensory nerves (which send stimuli related to pain, perception of vibrations, touch and balance to the brain) and motor nerves (which transmit nerve impulses to the muscles that govern voluntary and involuntary movements such as breathing, heartbeat, bowel movements).
In Guillain-Barré syndrome the sheaths that cover the nerve fibers (myelin sheaths) or the nerve fibers themselves – we can read on the ISS website – are attacked by mistake by the body’s defense system (autoimmune reaction); this causes the slowing down, or the interruption, of the transmission of nerve signals with the consequent appearance of a paralysis of the muscles often accompanied by sensory and functional alterations.
The cause of Guillain-Barré syndrome has not been identified. The disease occurs more often in adults and is slightly more common in males than in females. It usually appears after an infection. In two out of three cases, a few days or weeks before the onset of the syndrome, infections of the respiratory tract or gastrointestinal tract occur. Among the most frequent infections: food poisoning, mainly caused by the bacterium Campylobacter jejuni; influenza A virus; herpes virus infections (Cytomegalovirus, Epstein-Barr virus); respiratory tract infections due to Mycoplasma pneumoniae or Haemophylus influenzae.
Guillain Barrè syndrome is not contagious. It is believed to be the result of a autoimmune reaction directed against the myelin sheath that lines the nerve or against the nerve itself; this reaction would be triggered by an infection that induces the production of antibodies directed against nerve molecules (autoantibodies) mistakenly mistaken for components of the infectious agent.
The illness it can evolve towards total paralysis and respiratory failure which can endanger the person’s life. In these cases, assisted breathing and feeding through so-called parenteral nutrition may be necessary, in which the administration of nutrients takes place through a peripheral vein. There is no cure for Guillain-Barré syndrome but two types of therapeutic interventions, when performed rapidly, can accelerate healing and reduce the duration and complications of the disease: plasmapheresis and immunoglobulin infusion.
The characteristic disorder of the onset of Guillain-Barré syndrome is progressive weakness which can affect both legs and arms accompanied by reduced tendon reflexes of the affected limbs. Generally, initially the weakness affects the lower limbs and then spreads to the upper limbs; in a small percentage of people it manifests itself as paralysis of the upper limbs or lower limbs. The cranial nerves may also be affected resulting in weakness of the facial muscles.
Ascending muscular paralysis, that is to say that it spreads from the bottom up, can also involve other functions causing: difficulty in breathing; speech disorders; difficulty swallowing; changes in heart rate; cardiac arrhythmias; changes in blood pressure; changes in body temperature. The onset of the syndrome is usually rapid; complaints reach a stationary phase within 2-4 weeks and recovery usually begins within 6-8 weeks but can last several months or years. The severity and duration of the disease range from mild weakness, usually associated with spontaneous recovery, to total paralysis with respiratory failure.
Most people affected by the disease require hospitalization and supportive therapies: from constant monitoring of respiratory and cardiac function to prevention of deep vein thrombosis, from the management of possible intestinal and urinary dysfunctions to the early start of physiotherapy.
There is no cure for Guillain-Barré syndrome but two types of therapeutic interventions, when performed rapidly, can accelerate healing and reduce the duration and complications of the disease: plasmapheresis and immunoglobulin infusion.
Plasmapheresis is a procedure that consists in taking blood and separating the liquid part (plasma) from the cellular part which is then reinfused into the body; its effectiveness in Guillain-Barré syndrome is due to the elimination from the blood of antibodies that contribute to damage to peripheral nerves.
Intravenous infusion of high doses of immunoglobulins, containing antibodies from the blood of healthy donors, is intended to block the action of nerve-damaging antibodies.
Pain relievers may also be given to relieve pain, which can be very intense.
Anticoagulant medicines (heparin) and the use of compression stockings can be helpful in preventing blood clots and helping to return blood to the heart.