I-Guillain-Barré syndrome (i-GBS), noma i-Acute Inflammatory Polyradiculoneuritis, yisifo sokuzilimaza esidala ukulimala kwemizwa yomzimba nokukhubazeka. Lokhu kukhubazeka kuthiwa kukhulu ngoba ngokuvamile kuqala emilenzeni nasezingalweni bese kudlulela kuwo wonke umzimba. Kunezimbangela eziningi, kepha isifo sivame ukwenzeka ngemuva kokutheleleka, yingakho elinye igama le-postinfectious polyradiculoneuritis. Unyaka ngamunye eFrance, umuntu oyedwa kwababili kwabayishumi bayathintwa yilesi sifo. (1) Iningi labantu abathintekile balulama ngokuphelele ezinyangeni ezimbalwa, kepha lesi sifo singashiya umonakalo omkhulu futhi, ezimweni ezingavamile, siholela ekufeni, imvamisa ngokukhubazeka kwemisipha yokuphefumula.

Ukuthinta nokuzwa kwangaphandle kuvela ezinyaweni nasezandleni, kuvame ukulingana, bese kusabalala kuze kufike emilenzeni, ezingalweni nakuwo wonke umzimba. Ubukhulu nenkambo yesifo buyehlukahluka kakhulu, kusuka ebuthakathakeni obulula bemisipha kuya ekukhubazekeni kwemisipha ethile futhi, ezimweni ezinzima, cishe ukukhubazeka okuphelele. Iziguli ezingama-90% zithola umonakalo omkhulu kakhulu phakathi nesonto lesithathu kulandela izimpawu zokuqala. (2) Ngamafomu abucayi, ukubikezelwa kusongela impilo ngenxa yokulimala kwemisipha ye-oropharynx nemisipha yokuphefumula, okubeka ingozi yokwehluleka kokuphefumula nokumiswa. Izimpawu ziyefana nakwezinye izimo ezifana ne-botulism ((+ link)) noma isifo seLyme.

Ukulandela ukutheleleka, amasosha omzimba akhiqiza ama-autoantibodies ahlasela futhi alimaze i-myelin sheath ezungeze imicu yezinzwa (ama-axon) ezinzwa zomngcele, ebavimbela ekudluliseleni amasiginali kagesi ebuchosheni aye emisipheni.

Imbangela yesifo i-Guillain-Barré syndrome ayikhonjwa ngaso sonke isikhathi, kepha kokuthathu kwamacala kwenzeka ezinsukwini noma emasontweni ambalwa ngemuva kohudo, isifo samaphaphu, umkhuhlane… Ukutheleleka ngamagciwane I-Campylobacter (ebhekele izifo zamathumbu) ingenye yezinto eziyinhloko izici eziyingozi. Ngokuvamile, imbangela kungaba ukugoma, ukuhlinzwa, noma ukuhlukumezeka.

Lesi sifo sithinta abesilisa kaningi kunabesifazane nabantu abadala kunezingane (ingozi inyuka ngokukhula). Isifo i-Guillain-Barré syndrome asithathelani futhi asizaleli njengefa. Kodwa-ke, kungaba nokuthambekela kofuzo. Ngemuva kokuphikisana okukhulu, abacwaningi baqinisekise ngempumelelo ukuthi i-Guillain-Barré syndrome ingabangelwa ukutheleleka ngegciwane le-Zika. (3)

Izindlela zokwelashwa ezimbili ze-immunotherapy ziyasebenza ekunqandeni ukulimala kwezinzwa:

• I-Plasmapheresis, equkethe ukufaka esikhundleni se-plasma yegazi equkethe ama-autoantibodies ahlasela izinzwa nge-plasma enempilo.
• Ukujova ngomjovo wama-antibodies (ama-immunoglobulins emithanjeni) okuzodambisa ama-autoantibodies.

Zidinga ukulaliswa esibhedlela futhi zizosebenza ngempumelelo enkulu uma zisetshenziswe kusenesikhathi ngokwanele ukukhawulela ukulimala kwezinzwa. Ngoba lapho imicu yezinzwa evikelwe yi-myelin sheath nayo ithinteka, i-sequelae iyahlehliswa.

Ukunakekelwa okukhethekile kufanele kukhokhelwe okungahambi kahle ekuphefumuleni, ekushayeni kwenhliziyo nasekucindezelweni kwegazi, futhi isiguli kufanele sibekwe kumoya osizayo uma ukukhubazeka kufinyelela ohlelweni lokuphefumula. Kungase kudingeke izikhathi zokuvuselela ukuze kutholakale amakhono aphelele ezithuthi.

Isibikezelo ngokuvamile sihle futhi ngcono isiguli sisencane. Ukubuyiswa kuqedwa ngemuva kwezinyanga eziyisithupha kuya kweziyishumi nambili kumacala angaba ngu-85%, kepha cishe abantu abayi-10% abathintekile bazoba ne-sequelae ebalulekile (1). Lesi sifo sibangela ukufa kwamacala angama-3% kuya ku-5% ngokusho kwe-WHO, kodwa kuze kufike ku-10% ngokusho kweminye imithombo. Ukufa kwenzeka ekuboshweni kwenhliziyo, noma ngenxa yezinkinga ezivela ekuvuseleleni isikhathi eside, njengokutheleleka nge-nosocomial noma i-pulmonary embolism. (4)