Guillain-Barré Syndrome (GBS

Guillain-Barré Syndrome (GBS) is an acute immune-mediated polyneuropathy that results in the rapid development of weakness in the muscles of the limbs and often also includes the muscles of the face, swallowing and respiration.1,2 Common symptoms associated with GBS include weakness, pain, tingling in the limbs and loss of deep tendon reflexes.1,2,3 The cause of GBS is still undergoing investigation, but it is believed to be the result of a preceding bacterial or viral infection. Currently, GBS is diagnosed via a spinal tap that examines cerebrospinal fluid for elevated levels of albumin and through electrophysiology studies which demonstrate decreased conduction velocities.3 There have been many proposed treatments for Guillain-Barré Syndrome

One important component in the treatment of Guillain-Barré is the management of the patient’s pain. In a systematic review conducted by Liu et al,2 three short-term randomized controlled trials with a total of 277 patients with GBS were found that met the criteria for inclusion into their review of pain treatment methods in patients with Guillain-Barré Syndrome. In order to be included into the review, studies had to be randomized controlled trials or quasi-randomized controlled trials and that reported on pain assessment. The first study included in the review had eighteen participants and compared gabapentin to a placebo for seven days. At the conclusion of the trial, participants who received gabapentin reported lower pain ratings than did the control group receiving a placebo. In a second study including thirty-six participants, participants received either gabapentin, carbamazepine or a placebo for seven days. The participants that received the gabapentin reported lower pain ratings compared to the

Pritchard et al1 conducted a systematic review of randomized controlled trials (RTCs) that examined the effects of pharmacological agents other than plasma exchange, corticosteroids and immunoglobulins in the treatment of acute stage Guillain-Barré Syndrome. Researchers included only studies whose treatments focused on symptoms of weakness rather than pain or fatigue and outcomes were based on improvements in disability rating. The four studies that were included in the review looked at the effectiveness of interferon-beta 1a (IFNb-1a), brain-derived neurotrophic factor (BDNF), cerebrospinal fluid filtration (CSF filtration) and a Chinese herbal medicine, Tripterygium polyglycoside. The first study included thirteen participants receiving IFNb-1a and six receiving placebo. The treatment was administered three times a week and was discontinued after twenty-four weeks or if the participant began walking without aid. At the conclusion, the placebo group showed more improvement in their disability grade (.10) than the group receiving the IFNb-1a treatment. The second RTC that was reviewed included ten participants and compared BDNF to a placebo. The BDNF groups disability score improved 0.75 more than the placebo group but was statistically