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School of Medicine
NeuroNow - Beating Back Guillain-Barre Syndrome
NeuroNow Summer 2013
Beating Back Guillain-Barre Syndrome
Date: May 20, 2013
Jeff Dalton, diagnosed with Guillain-Barre syndrome and treated at Johns Hopkins, married his girlfriend, Christina, late last year.
When Jeff Dalton woke up one April morning last year, he immediately knew something was wrong. His legs felt incredibly weak as he swung them out of bed.
“They felt like Jello,” he says. “I’d never experienced anything like it.”
The 46-year-old pushed through his workday as a road crew foreman for the Maryland State Highways Administration, even cutting grass on his riding lawn mower when he got home. But the weakness was still there the next morning, and it had taken a turn for the worse. He could barely walk, and his arms and hands felt numb and tingly.
Worried that he was having a stroke, Dalton headed to a local hospital emergency room with several family members. Tests didn’t turn up an obvious culprit for his problems. But the doctor he saw did mention the possibility of Guillain-Barre Syndrome (GBS), a condition in which the immune system, for unknown reasons, turns on the insulation that coats nerve fibers. Because nerves need this insulation to effectively send signals to muscles for movement and from the skin to the brain for sensation, this attack and subsequent destruction can lead to progressive paralysis and loss of feeling. The disease is thankfully rare, affecting only one or two people per 100,000.
The emergency room doctor suggested that Dalton see a neurologist, so he headed home to wait five days until the next open appointment. However, his symptoms quickly grew worse. Fearing now for his life, Dalton headed to the emergency room at The Johns Hopkins Hospital. There, doctors led by Department of Neurology Director Justin McArthur confirmed that Dalton indeed had GBS.
“After we admitted him, Jeff went from being weak in the legs to completely paralyzed, losing the ability to speak or swallow within a day,” McArthur says. “To be wide awake and paralyzed is a terrifying experience.”
McArthur and his team soon scheduled Dalton for plasmapheresis, a treatment in which the blood’s plasma is filtered to remove components responsible for triggering the immune response. Dalton received daily treatments over five days.
Initially, the treatments had no effect. When Dalton left Johns Hopkins nearly two weeks after he’d arrived to head to a rehabilitation facility, machines were still breathing for him. One of his eyes drooped completely closed, and the other opened only halfway despite his best efforts. Dalton was only able to move his feet, and then only barely. With that minimal motion, he was able to communicate with his care providers and family members using a letter board his then-girlfriend had constructed. With one foot labeled yes and the other no, he painstakingly spelled out words, asking questions, making comments—and eventually proposing to his girlfriend, Christina, who said yes.
Within weeks, Dalton began to make progress. Tracking his care from afar as Dalton proceeded to various rehab and other care facilities, McArthur saw that Dalton began to breathe on his own and become stronger, eventually regaining the ability to take bites from a cheeseburger and take the first steps since he became ill. On December 28, Dalton married Christina.
McArthur, who still sees Dalton every two months, says he expects him to continue to progress, perhaps even coming back fully from this daunting ordeal. “We get used to seeing people respond to antibiotics and other medicines within hours or days,” McArthur says. “Neurological recovery takes a very long time, but this man is determined to recover. His prognosis is quite good.”
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