Medical Experts

Hi Mary: Weakness in CIDP can fluctuate a little but it does not typically have this pattern of being consistently better in the morning and then worsening as the day progresses. That pattern is more reminiscent of a disease called myasthenia gravis or, less likely, a rare condition called Lambert-Eaton myasthenic syndrome. You should make sure your neurologist is aware of the pattern of the weakness and that these conditions have been considered. Since you have already seen a neuromuscular specialist I am sure that they have but it doesn’t hurt to ask.

Pain in the region of the joints is unlikely to be a direct effect of GBS. It is probably because of the strain on your joints due to the abnormal gait. Pain from the GBS nerve damage (neuropathic pain) is usually in the feet and is usually worse during the night. Pregabalin can be helpful with different types of pain but one of the known side effects is foot swelling. Nothing usually needs to be done about it and it will subside when you are able to stop the drug. The pregabalin dose could be increased to 3x daily for better pain control but discuss with your doctor. Pain almost always resolves over a few months, maybe up to a year.

Hi Rex: I do not have enough information to be able to comment. Please answer the following: 1. How old are you? 2. When did you have GBS? 3. How severe was your weakness; i.e., were you able to walk? If you were unable to walk how long were you bed-bound. 4. Is the swelling only when you are upright; i.e., is it still there when you get up in the morning? Gareth

Hi Nicole: According to the GBS Foundation International recommendations the only situation in which vaccination should be avoided is if the GBS was unequivocally triggered by a vaccination. In that case that specific vaccine, but not others, should be avoided. There is an equivocal recommendation that vaccines should be avoided for the 1st year following the acute event but that is really only if there has been poor recovery. The risk of having GBS following any vaccination is almost always outweighed by the risk of the infections against which you are being vaccinated. You should discuss this with your GP. Many vaccines carry a warning in their product information about their use in patients that have ever had GBS but that is a recommendation driven by fear of litigation rather than data.

Hi Lucy: I passed on your question to Suzie Mudge who is a physio and a member of the Medical Advisory Board who is an expert on rehabilitation and muscle fatigue. Here is her answer.

Our muscles are made up of thousands of motor units (motor unit = motor nerve and muscle fibres that it supplies). Following GBS, you might recruit fewer motor units (depending on the amount of recovery you’ve had). You can often compensate by increasing the size and efficiency of the motor units that are working. But this leads them to be more at risk of overworking, which can lead to muscle &/or central fatigue. So sorry for being so technical but the short answer is that even though you make a good motor recovery, you are likely to experience more fatigue than previously.