Anatomy and Physiology

Guillain-Barr syndrome (GBS) 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 symmetrical
weakness and abnormal sensations spread to the arms and upper body. These symptoms can
increase in intensity until certain muscles cannot be used at all and, when severe, the person is
almost totally paralyzed. In these cases the disorder is life threatening potentially interfering with
breathing and, at times, with blood pressure or heart rate and is considered a medical emergency.

The patient mentioned that on January 4, he celebrated his birthday alone by eating roasted
chicken. Poultry consumption has been identified as a major risk factor for human infection with
Campylobacter jejuni in developed countries. C. jejuni is present in the gastrointestinal tract of broiler
chickens at the time of slaughter, and faecal contamination of carcases during processing results in
significant campylobacter loads on carcases. C. jenuni enters the body by the use of multifenestrated cells
or other mechanisms, innate immune response results in the uptake of the pathogens by immature antigen
presenting cells and then migration to lymph nodes occurs, a mature, differentiated antigen presenting cell
can present in major histocompatibility complex molecules and activate CD4 T cells that recognize
antigens from the infectious pathogen. B cells can be activated as well by newly activated Th2 cells. This
produces a cell-mediated and humoral response against the pathogen. And then antibodies will be
produced, leading to activation of the complement system and phagocytosis of the bacteria. Pathogen and
host have homologous or identical amino acid sequences, antigens in its capsule are shared with nerves.
There will be a molecular mimicry, infectious organism contains an amino acid that mimics the peripheral
nerve myelin protein. Autoimmune activation results in the damage and dysfunction of target organs. The
immune response directed against the capsular components produce antibodies that cross-react with
myelin. L:ymphocytes and macrophages circulate in the blood and eventually find myelin. Lymphocytic
infiltration of spinal roots and peripheral nerves, followed by macrophage-mediated, multofocal, stripping
of myerlin and axonal damage. Defects in the propagation of electrical nerve impulses, with eventual
conduction block that will eventually lead to peripheral nerve denervation and atrophy. Autonomic
Nervous System involvement with dysfunction in the sympathetic and parasympathetic systems can be
observed in patients with GBS. This includes sensory changes paresthesias or numbness in feet or hands,
acute progressive ascending weakness, weakening of the diaphragm and respiratory muscles and etc.
If treated early, the cell body will survive, peripheral nerves will be regenerated and there will be
recovery of motor function. If not treated, there will be extensive axortal destruction, ascending weakness
progression, weakening of the diaphragm and the respiratory muscles, respiratory arrest, shock and the
worst-case scenario is death.