Symptoms

Frequently, 2-4 weeks after an infection of the upper airways or gastrointestinal tract, paralysis often begins at first. The paralysis rises from the bottom to the top, up to a high level of paraplegia (tetraplegia), in which neither arms nor legs can be moved. If the diaphragm is involved, breathing is also stopped and the patient must be ventilated.

Respiratory paralysis occurs in about 20% of patients. The cranial nerves (neuritis cranialis) can also be involved and can lead to swallowing difficulties as well as facial paralysis (facial paresis). Facial paralysis results in difficulties in speaking and chewing, as well as reduced lacrimation and reduced salivary secretion.

In rare cases, eye movement disorders also occur. The involuntary (autonomic, vegetative) nervous system is also affected. Vegetative symptoms include sweat secretion disorders, cardiac arrhythmia, blood pressure and temperature fluctuations, pupillary movement disorders (pupillomotor function), high blood sugar levels (hyperglycemia) and disorders of bladder and bowel emptying. The peak of the disease occurs in 90% of patients within 3-4 weeks.

Uncharacteristic back pain
Sensory discomfort, especially from the middle of the body (distal paresthesia)
Numbness of the feet
Then motoric symmetrical weakness of the legs (walking becomes difficult or impossible)
Muscle pain (myalgia)
Pain emanating from the nerve roots and coordination problems when standing and walking due to lack of depth sensitivity (ataxia).

Diagnosis

Medical history (anamnesis): in particular, previous, unspecific infections of the respiratory tract or gastrointestinal tract play a role. Examination of the nervous system : conspicuous are loss of muscles (paralysis, pareses), absence of reflexes (areflexia) and sensitivity disorders. Collection and examination of cerebrospinal fluid (CSF puncture for CSF diagnostics): clear cerebrospinal fluid, normal to slightly increased cell count, sugar normal, protein increased to >100mg/dl with signs of a barrier disorder (typical is a so-called cytoalbuminary dissociation).

The nerve conduction velocity (NLG) is partially slowed down up to the conduction block. Electromyography (EMG), with which the activity of the muscle can be recorded, shows an inadequate or missing supply of nerve signals to the muscles (denervation signs). With the help of a tissue sample taken from a nerve (nerve biopsy), a demyelination of the nerves (demyelination) can be detected under the microscope (histlogical-pathological). Pathogens (Campylobacter jejuni, Epstein-Barr-Virus, Varicella-Zoster-Virus, Mycoplasma, Leptospires, Rickettsia) can be detected in the blood in some cases.