Doctors estimate the incidence is at least 30-50% higher than the usual numbers seen during the monsoon season when GBS cases typically increase slightly.
Neurologists say the rise is significant in both outpatient cases as well as admissions. The civic-run BYL Nair Hospital, for example, has treated over 15 GBS cases in just one month, with six patients currently receiving treatment.
Private centres like Andheri’s Kokilaben Hospital and Bhatia Hospital in Tardeo have each treated more than a dozen cases since July, and Fortis and Lilavati hospitals are currently treating three to five patients each. Many of these patients have required ventilator. The good news is none of these hospitals have reported any fatalities.
Many GBS patients also have a travel history, doctors say
Although the exact cause of the increase in cases of Guillain-Barre syndrome (GBS) in the city remains unclear, doctors suspect it could be linked to a broader rise in viral infections. Dr Rahul Chakor, head of the neurology department at Nair Hospital, noted that nearly all his GBS patients developed the condition shortly after recovering from a viral or gastrointestinal infection. This surge has affected people of all ages and genders.
Dr Nilesh Chaudhary, a neurologist at Hiranandani Hospital, also pointed out most GBS cases follow a viral or bacterial infection, causing the immune system to mistakenly attack the body itself. The condition typically causes muscle weakness, numbness or tingling as the nerves come under attack, and can progress to paralysis, requiring long recovery. The increase in cases has become noticeable over the past 30-45 days, with a nearly 50% rise than usual, according to Dr Chaudhary. Interestingly, Bhatia Hospital neurologist Dr Ashish Gosar observed that many of his GBS patients also had a travel history.
However, doctors are noticing not only a surge but also several variants of GBS. The presentation at times is atypical and not classic-where the weakness starts from lower limbs and progresses up, said Dr Gosar. Of the dozen cases in the hospital, Bhatia doctors have also noticed that younger patients, those with early cranial nerve involvement (having swallowing difficulty, double vision) and upper limb involvement at onset of disease are progressing rapidly and requiring ventilatory support because of weakness of respiratory muscles.
At Fortis Hiranandani in Vashi, Dr Pawan Ojha, director of neurology, said they have four patients with severe GBS symptoms. Two have the Acute Inflammatory Demyelinating Polyneuropathy (AIDP) variant, and two severe Acute Motor Axonal Neuropathy (AMAN). In AIDP, the protective cover of nerves is affected, causing weakness, tingling, and numbness in limbs. In AMAN, the long threads that transmit nerve signals called axons are affected. “All of them required mechanical ventilation and plasma exchange therapy,” he said.
Most patients have come to the emergency department with complaints of weakness, tickling and numbness, said Dr Tushar Raut of Kokilaben Ambani Hospital. He cautioned that if a person is suspected of GBS, they must be monitored closely for breathing, heart rate, and blood pressure.
Calling the rise alarming, Dr Girish Soni of Lilavati Hospital said that it requires documentation as most patients experience a gradual recovery stretching 6 to 12 months. The cost of treatment, pointed out Dr Chakor, could be in lakhs in private hospitals as each patient requires immunoglobulins worth Rs 2-3lakh in addition to supportive therapies. However, complete recovery is seen in the majority.
Is there a link with Covid-19? According to Dr Chakor, almost all autoimmune conditions have seen a surge post pandemic, but if GBS is linked anyhow will need deeper research.
