Journal of Physiotherapy & Physical Rehabilitation

Enhancement of Recovery with Physical Therapy Management in Patient of Rare Variety of Gullain Barre Syndrome: A Case Report

Abstract

Snehal Waghavkar and Suvarna Ganvir

Guillain-Barré Syndrome (GBS) is an immune mediated peripheral neuropathy as it is caused by the body's immune system mistakenly attacking the peripheral nerves and damaging their myelin insulation. Sometimes this immune dysfunction is triggered by an infection primarily characterized by rapidly evolving symmetrical limb weakness. The weakness can be variable, from minimal lower extremity weakness to total paralysis of all extremities and trunk. Symptoms become more severe until they reach maximum expression, called the nadir; a plateau phase of 2-4 weeks follows, and recovers completely within 1 month after the onset. But in rare cases there is a gradual resolution of the paralysis that can last 1-2 years and the patient recovers within a period of 6 months to 2 years. The patient being reported in this case study is a 40 year old male diagnosed with GBS and reached a plateau phase within a month and recovery is not complete even after 6 months (till today). The aim of this study was to report the effect of Physical therapy management for enhancement of recovery in patient with rare variety of Gullain Barre Syndrome. 40 year old patient diagnosed as a case of GBS was referred to Physiotherapy, Vikhe Patil Memorial Hospital, Ahmednagar 6 months back. It was expected that recovery would occur within a period of maximum 12 weeks. The patient was received Proprioceptive Neuromuscular Reeducation, Therapeutic Exercises in supine and Sitting, Electrical Muscle stimulation (Faradic stimulation to Quads and IG to intrinsic muscles of hand and foot) and bed mobility training. Outcome measures were MMT, Barthel Index, and Functional Indepedence Measure and DeMorton Mobility Index. The result of case report showed that there was statistically significant improvement in all outcome measures which includes MMT, Barthel Index, and Functional Indepedence Measure and DeMorton Mobility Index. Hence, the study concluded that the recovery in patients with GBS may be delayed in contrast to the reported literature and may take more than 6 months as in the present case.