What are the Differences Between Multiple Sclerosis and Guillain-Barre Syndrome?

Multiple Sclerosis and Guillain-Barre are two demyelinating conditions that directly affect the the nervous system (CNS). Folks with either of these conditions have a loss of myelin, which is the protective cover of the axons in the neurons.

Both illnesses are autoimmune disorders, which mean that the immune system attacks the body, resulting in inflammation. Guillain-Barre is a rare neurological condition. The National Institute of Neurological Disorders and Stroke (NINDS) noted that one in 100,000 people have the Guillain-Barre disorder and there are approximately 400,000 persons afflicted today by MS in the United States alone.

WHAT IS THE MAIN DIFFERENCE HERE?

Although both illnesses are demyelinating conditions, they affect different types of myelin.

In the case of Multiple Sclerosis, it is a demyelinating disease of the central nervous system (CNS), which includes the brain and spinal cord. Guillain-Barre is a demyelinating disease of the peripheral nervous system, which are the nerves outside of the brain and spinal cord.

The cells that make up the myelin in the central nervous system (CNS) and peripheral nervous system are different: CNS myelin is fromoligodendroglia and PNS myelin is from Schwann cells.

OTHER IMPORTANT DIFFERENCES

The process of demyelination in Guillain-Barre has a rapid onset, occurring within hours or days.

Usually, weakness begins in both legs and moves up the body. In about 80% of the cases, symptoms begin about 5 days to 3 weeks after a mild infection (such as a Campylobacter infection, mononucleosis, or another viral infection), surgery, or an immunization.

Some of the most frequently seen problems caused by Gillain-Barre are:

1. Patients can have muscle weakness or paralysis that may become worse in a 24 to 72 hour time frame.
2. With severe symptoms, you may need to be hospitalized and those cases may require artificial breathing support. Approximately, in 5 to 10% of the cases the muscles that control breathing become so weak that a ventilator is needed.
3. Symptoms include weakness and a pins-and-needles sensation or loss of sensation. Weakness is more prominent than abnormal sensation.
4. Reflexes are decreased or totally absent in 90% of folks presenting Guillain-Barre syndrome.
5. Because the facial and swallowing muscles become weak, some folks need to be fed intravenously or through a tube placed directly through the abdominal wall into the stomach (gastrostomy tube).

In a variant called Miller-Fisher syndrome, only a few symptoms develop:

• Eye movements become paralyzed
• Walking becomes difficult
• Normal reflexes disappear

WHAT SHOULD YOU DO IF GUILLAIN BARRE IS CONFIRMED

Establishing the diagnosis is crucial because the sooner appropriate treatment is started, the better the chance of a good outcome. If you or someone you love is admitted into a hospital, the patient will be closely monitored so that breathing can be assisted with a ventilator if necessary. You may want to make sure that precautions are taken to prevent pressure sores and injuries by asking the hospital for soft mattresses and by keeping a close watch over the bed turning every 2 hours with a patient with severe weakness.

If weakness is less severe, physical therapy is started to help preserve joint and muscle function. Heat therapy may be used first to relieve pain and thus make physical therapy more comfortable.

HOW IS IT DIAGNOSED?

A combination of high protein levels and no inflammatory cells in the cerebrospinal fluid taken via a spinal tap (lumbar puncture) and characteristic results from electromyography are usually strong suggestions of Guillain-Barré syndrome.

WHAT IS THE TREATMENT USUALLY PRESCRIBED

Plasmapheresis (filtering of toxic substances, including antibodies to the myelin sheath from the blood) or immune globulin given intravenously is the treatment of choice. These treatments are relatively safe, shorten the hospital stay, speed recover, and reduce the risk of death and permanent disability.

A main difference with Multiple Sclerosis is that treatments with Corticosteroids such as Solu-Medrol do not help at all and may worsen the syndrome.

WHAT IS THE PROGNOSIS HERE?

Normally the damage stops progressing within 8 weeks. If there is no treatment at all, most folks would improve slowly over several months. On the other hand, with early treatment, you can improve very quickly (in a matter of days or weeks).

About 30% of adults and even more children with the disorder have residual weakness 3 years after the syndrome began. On average, less than 2% of folks suffering from Guillain-Barre syndrome die.

After improving initially, 3 to 10% of patients develop a disorder called chronic inflammatory demyelinating polyneuropathy

SOME FINAL NOTES

You can easily see how Guillain-Barre syndrome can easily be confused with MS symptoms at first glance.

Difficulties with movement and paralysis are not uncommon MS symptoms but MS targets the Central Nervous System (CNS) while Guillain-Barre targets the Peripheral Nervous System (PNS).

In other words, they target different systems. So while both conditions may induce weakness, the weakness is actually caused by damage to different areas of the body.

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