Freddie Freeman’s son, Max Freeman, is back home after spending eight days in the pediatric intensive care unit battling Guillain-Barré syndrome, a rare, life-threatening form of paralysis. “Max still has a long way to go to regain his strength and relearn how to walk. But we are so grateful to have our family together again,” Los Angeles Dodgers first baseman Freddie and his wife, Chelsea, posted on Instagram Sunday.
Max (short for Maximus) “rapidly declined and was left with full-body paralysis,” Chelsea wrote in a previous post. The 3-year-old boy spent several days on a ventilator to support his lung function before his condition improved enough for his breathing tube to be removed.
Guillain-Barre is rare, especially among children, but it can affect anyone. The good news is that in most cases – including Max’s – people recover. So how can someone suddenly become paralyzed by this disorder and then regain function? Here’s what you should know.
What is Guillain-Barré syndrome?
Guillain-Barre is an autoimmune disease, meaning it occurs when the immune system attacks healthy tissue, according to the Centers for Disease Control and Prevention. In the case of Guillain-Barré syndrome (GBS), these attacks are carried out against peripheral nerves (those found outside the brain and spine), damaging the protective layer that surrounds them, which in turn confuses or blocks signals between the brain and body. Interference with this communication causes muscle weakness and paralysis.
What causes GBS?
There is no single cause, but scientists believe most cases occur after people have become ill with viral or bacterial infections that scientists believe trigger GBS. “The body provides antibodies to this infection, but the antibodies cannot distinguish the virus [or bacteria] and start attacking part of the nervous system,” Dr. Aarti Sarwal, chief of neurocritical care at Virginia Commonwealth University, told Yahoo Life.
The disease most closely linked to GBS is Campylobacter infection, a gastrointestinal disease that is typically acquired from undercooked poultry, according to the Mayo clinic. But “any type of infectious process can trigger an abnormal immune response,” Dr. Kunal Desai, an expert in neuromuscular medicine at Yale University, told Yahoo Life. These include flu, COVID-19, and hepatitis A, B, C, or E. Symptoms usually appear between two and four weeks after becoming ill.
Who gets GBS?
Only one or two in every 100,000 people in the U.S. develop Guillain-Barre syndrome in a given year, according to the CDC. The main risk factor is a recent bacterial or viral infection, regardless of the person’s age, sex, race or ethnicity. Other than campylobacter, one disease is no more likely to trigger GBS than another, although, Sarwal notes, patterns vary regionally based on the types of infections most common in a given location.
The disorder affects adult men more often than women, and risks increase as people age, according to the World Health Organization. But the disorder can affect anyone, including young children like Max Freeman.
What are the early warning signs?
Paralysis caused by GBS can progress quickly, experts warn, but it often begins with numbness, weakness or tingling in more distant extremities. “It’s almost like a glove,” explains Sarwal. “It progresses from the fingertips to the arms and shoulders and marches toward the body,” or from the toes to the legs, she says. Muscle weakness gives way to paralysis, which tends to progress symmetrically on both sides of the body. However, there are many different GBS subtypes, therefore symptoms may vary; for some, the first signs are changes in vision or difficulty maintaining balance.
How is GBS treated?
Because the disorder can cause the lungs to stop working, it’s critical to see a doctor immediately if you notice progressively worsening weakness or tingling—regardless of whether or not you remember being sick recently (you can be asymptomatic during many infections, as has become abundantly clear amid the COVID pandemic).
Most of the care GBS patients receive is supportive, but immunoglobulin infusions, a type of immunotherapy, are often used to help normalize immune system behavior, explains Sarwal. If this does not help, patients may choose to undergo a procedure called plasmapheresis, in which “the blood is cleaned of [off-target] antibodies,” says Sarwal. These treatments are carried out in hospitals, where – most importantly – ventilators like the one Max Freeman used are available to support breathing during recovery if the lungs or throat become paralyzed.
Is the disorder fatal or permanent?
Guillain-Barr can certainly be fatal, although most people recover completely or nearly completely, depending on the Mayo clinic. The condition becomes dangerous if the paralysis spreads to the lungs and muscles that control swallowing. Between 20% and 30% of all patients diagnosed with Guillain-Barré syndrome reach this precarious stage and must be placed on mechanical ventilators in an ICU to ensure they continue to receive sufficient oxygen.
Severe cases can result in permanent paralysis, the WHO says, but they are by far a minority. O American Brain Foundation estimates that around 30% of people will still experience some weakness three years after the initial diagnosis, and 15% will have long-term weakness.
The good news, according to ABF, is that 70% of people fully recover. But, as the Freemans say, it’s a long road. Depending on the affected muscles, patients may need physical therapy to regain strength and may need occupational or speech therapy if hand or foot dexterity, or facial or throat muscles are affected, Desai says. “Recovery can take weeks to months, including up to 12 or 24 months in rare cases,” she adds.
Vaccines and GBS
There is some debate about whether the immune response that vaccines are designed to provoke can trigger GBS. According to CDC, people are more likely to develop Guillain-Barre after having the flu than after getting the flu vaccine, suggesting that a flu vaccine may reduce both people’s risks of getting an infection It is GBS. Sarwal – an expert from Guillain-Barre – calls the suggested link between the syndrome and vaccines an “urban myth,” while Desai says that “anything that can trigger the immune system can trigger this abnormal response, [but] It’s extremely rare.”
