On the cold morning of January 31, 2006, Nitin Narain, a 25-year-old Delhi native, began experiencing unusual fatigue, accompanied by stiffness in his hands and legs.
Initially, he attributed the symptoms to the cold weather in Delhi, thinking it might just be the climate affecting him. However, as days passed, his condition worsened, and he began feeling muscle pain, fatigue, and weakness. Despite this, he remained confident he could manage the situation on his own. But about a week later, he found himself unable to get up or eat, and realized something was seriously wrong. He was taken to a nearby hospital, where he was diagnosed with Guillain-Barre syndrome (GBS).
GBS is a rare autoimmune condition in which the immune system attacks the peripheral nerves. Although the global prevalence of the disease is one to four cases per one lakh people, there has been a recent spike in cases in Pune, Maharashtra, where 130 cases and three deaths were reported. The spread was linked to contaminated water. Dr. Rajeev Jayadevan, chairman of the IMA Research Cell, explained that GBS occurs when the immune system mistakenly attacks the body's own nervous system after responding to an infection. The immune system targets proteins in bacteria that resemble those found in the nervous system, damaging the myelin sheath, a protective covering of the nerves, in the process.
According to Dr. Sudheeran Kannoth, an autoimmune neurologist at Amrita Hospital in Kochi, GBS typically follows infections like viruses, bacteria, or diarrhea. The body's immune response to the invading organism eventually turns against its own nerves. In rare cases, vaccination can trigger the condition as well.
Symptoms of GBS include:
Tingling and numbness, often starting in the feet
Muscle weakness and pain
Difficulty walking
Early detection is crucial in managing GBS, as the disease progresses rapidly, particularly in the first two weeks. Dr. Syamlal S, a senior consultant in neurology at KIMSHEALTH in Thiruvananthapuram, emphasized the importance of consulting a doctor immediately when symptoms arise. "Starting treatment as soon as possible can prevent the progression and severity of the condition," he said. "Earlier, GBS was known as Laundry's ascending paralysis. It often starts with lower limb weakness, then spreads to the upper limbs and face. Severe cases can lead to fatality in around 6% of patients."
Nitin speculated that the cause of his GBS might have been a kebab he ate the day before his symptoms began. "Doctors and others suggested that GBS can be caused by bacterial or viral infections, especially from uncooked poultry. I suspect the kebabs were the culprit," he said. His treatment included medications and supportive care, and after two weeks at AIIMS in Delhi, he was discharged. However, full recovery took about six to seven months.
Dr. Rajeev Jayadevan pointed out that gastrointestinal and respiratory infections are the most common causes of GBS. Campylobacter bacteria, often transmitted through contaminated food or water, is the primary bacterial agent associated with the disease.
Advancements in medical technology and treatments have improved recovery rates for GBS. Treatments like immunoglobulin therapy (IVIG) and plasma exchange, which filters out the immune globulins causing the disease, have proven effective. In severe cases where respiratory muscles are affected, ventilator support may be required until recovery. Physiotherapy also plays a key role in recovery. Dr. Sudheeran noted that extensive physiotherapy during and after treatment can help patients regain strength, as the condition can last for up to a month or more.
For Nitin, extensive physiotherapy over several months was essential to regaining the ability to walk and return to his normal life. "Physiotherapy is crucial even after recovery. It took me six to seven months, but I was able to fully recover with the right treatment and support. Recovery is possible, as long as you remain hopeful," Nitin shared.