Guillain-Barre Syndrome

Adverse reaction to the Hepatitis B, Hepatitis A, Polio, MMR, DTaP, Varicella (chickenpox), Hib

and Influenza vaccines according to the manufacturer.

Acute Idiopathic Polyneuritis

<neurology, syndrome> Acute infective polyneuritis that results in a form of peripheral neuropathy with temporary loss of movement and sensation due to inflammation of multiple nerves and loss of myelin.

The exact cause is unknown but has been associated with an abnormal immune response to viral infection, particularly cytomegalovirus infection, in which there is cell-mediated immunity to a component of myelin. The disease may be autoimmune in origin and complete recovery can take up to six months.

Synonym: Guillain-Barre syndrome

(12 Jul 2000)

Scientific Citations:

• Sinsawaiwong S. Thampanitchawong P. Guillain-Barre syndrome following recombinant hepatitis B vaccine and literature review. J Med Assoc Thai. 2000 Sep;83(9):1124-6.
• Kakar A. Sethi PK. Guillain Barre syndrome associated with hepatitis B vaccination. Indian J Ped 1997 Sept-Oct;64(5):710-2.
• Influenza vaccination and Guillain Barre syndrome
  Mark R. Geier,a,* David A. Geier,b and Arthur C. Zahalskyc  Clinical Immunology 107 (2003) 116–121
• Gunderman, JR, "Guillain-Barre Syndrome. Occurrence Following Combined Mumps-Rubella Vaccine", Am J Disorder Child, Jun 1973, 125:834-835. [GBS is paralysis!]

Guillain-Barré (ghee-yan bah-ray) syndrome is a disorder in which the body's immune system attacks part of the peripheral nervous system. The first symptoms of this disorder include varying degrees of weakness or tingling sensations in the legs. In many instances, the weakness and abnormal sensations spread to the arms and upper body. These symptoms can increase in intensity until the muscles cannot be used at all and the patient is almost totally paralyzed. In these cases, the disorder is life-threatening and is considered a medical emergency. The patient is often put on a respirator to assist with breathing. Most patients, however, recover from even the most severe cases of Guillain-Barré syndrome, although some continue to have some degree of weakness. Guillain-Barré syndrome is rare. Usually Guillain-Barré occurs a few days or weeks after the patient has had symptoms of a respiratory or gastrointestinal viral infection. Occasionally, surgery or vaccinations will trigger the syndrome. The disorder can develop over the course of hours or days, or it may take up to 3 to 4 weeks. No one yet knows why Guillain-Barré strikes some people and not others what sets the disease in motion. What scientists do know is that the body's immune system begins to attack the body itself, causing what is known as an autoimmune disease. Guillain-Barré is called a syndrome rather than a disease because it is not clear that a specific disease-causing agent is involved. Reflexes such as knee jerks are usually lost. Because the signals traveling along the nerve are slower, a nerve conduction velocity (NCV) test can give a doctor clues to aid the diagnosis. The cerebrospinal fluid that bathes the spinal cord and brain contains more protein than usual, so a physician may decide to perform a spinal tap.

There is no known cure for Guillain-Barre syndrome.  It is life threatening and takes the lives of 15% cases.  Most people recover from even the most severe cases of GBS, although some people continue to have some weakness. However, long-term impairment is possible, with approximately 20 percent of those with GBS having permanent disability, and about two-thirds having ongoing fatigue.

Guillain-Barre Syndrome After Vaccination in United States

Newswise (press release)
Released: Mon 09-Oct-2006, 00:00 ET

Source: American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM)

Newswise — Although vaccines have reduced morbidity and mortality from many infections, several cases of Guillain-Barre syndrome (GBS) have been reported following vaccination.

A team of medical researchers at the Zeenat Qureshi Stroke Research Center set out to determine the occurrence and characteristics of GBS after isolated reports of the syndrome were found in patients who had received vaccinations. GBS is an inflammatory disorder in which the body’s immune system attacks part of the peripheral nervous system. The first symptoms of this disorder include varying degrees of weakness or tingling sensations in the legs. In many instances the weakness and abnormal sensations spread to the arms and upper body. These symptoms increase in intensity until certain muscles cannot be used at all and, when severe, the patient is almost totally paralyzed.

The research data was obtained from the Vaccine Adverse Event Reporting System (VAERS) which is a cooperative program for vaccine safety of the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA). The VAERS is a post-marketing safety surveillance program, collecting information about possible side effects that occur after administration of United States licensed vaccines.

There were 54 cases of GBS reported after vaccination in the United States in 2004. The number of vaccine related cases constituted 0.1% of the total admissions for GBS in the United States. Of the 54 cases studied, Guillain-Barre syndrome was observed in 57% of the patients who had received an influenza vaccine, followed by 22 % of the patients who had received a hepatitis vaccine either as a single vaccine or in combination with other vaccines. In the same study group, 11% of the patients with GBS had received the measles, mumps, and rubella (MMR) vaccine in combination with other vaccines, with the remaining study cases having received haemophilis B conjugate vaccine, tetanus and diphtheria toxoid, or typhoid vaccine. Up to 20 % of the patients developed GBS after receiving more than one type of vaccine.

According to Dr. Nizar Souayah, lead investigator and Assistant Professor of Neurology, New Jersey Medical School, “The benefits of receiving vaccinations far outnumber the risks. Few studies had been attempted to address the relationship between vaccination and GBS and most had focused only on the influenza vaccine. It is important to determine which vaccines may be associated with GBS.”

The results of the study suggest that vaccines other than influenza can be associated with GBS.

The complete findings and results of the study are being presented at the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM) 53rd Annual Meeting in Washington, DC, at the Marriott Wardman Park, October 11-14, 2006. The AANEM is the largest organization worldwide, with over 5000 members, dedicated to advancing neuromuscular, musculoskeletal, and electrodiagnostic medicine.