In the general management of GBS the most important requirement is close monitoring of respiratory function. Since the deltoid muscles share segmental innervation with the diaphragm, if the deltoids are too weak to elevate the arms, the diaphragm is also severely paralysed and this leads to paradoxical abdominal movement with respiratory distress in the supine position, and hypoventilation in sleep 5 . Patients are closely monitored so that breathing can be assisted with a respirator if necessary. Nurses take precautions to prevent bedsores and injuries by providing soft mattresses and by turning the patient every 2 hours. Physical therapy is important to prevent tightening of muscles and to preserve joint and muscle function 1 .
Current treatment includes plasmapheresis and high-dose immunoglobulin therapy.
Plasmapheresis is a method by which whole blood is removed from the body and processed so that the red and white blood cells are separated form the plasma. The blood cells, without the plasma, are then returned to the patient. Scientists still don't know exactly why plasmapheresis works, but the technique seems to reduce the severity and duration of the Guillain-Barre episode. This may be because the plasma portion of the blood contains elements of the immune system that may be toxic to the myelin. In high-dose immunoglobulin therapy, doctors give intravenous injections of the proteins that, in small quantities, the immune system used naturally to attack invading organisms 2 .