Multiple sclerosis and Guillain-Barré are two demyelinating conditions that affect the nervous system. Patients with either of these conditions have a loss of myelin, which covers the axons of the neurons. Both are autoimmune disorders, meaning the immune system attacks the body, resulting in inflammation. Guillain-Barré is a rare neurological condition: the National Institute of Neurological Disorders and Stroke (NINDS) noted that one in 100,000 people have the disorder. About 400,000 people in the United States have multiple sclerosis, according to the Merck Manual Home Edition.
While both of these conditions affect the myelin sheath, they affect different types of myelin. Multiple sclerosis is a demyelinating disease of the central nervous system, which includes the brain and spinal cord. Guillain-Barré is a demyelinating disease of the peripheral nervous system, which are the nerves outside of the brain and spinal cord. The cells that make up the myelin in the central nervous system and peripheral nervous system are different: CNS myelin is from oligodendroglia and PNS myelin is from Schwann cells.
The demyelination in Guillain-Barré has a rapid onset, occurring within hours or days. Patients can have muscle weakness or paralysis that may become worse in a 24 to 72 hour time frame, noted MedlinePlus. With severe symptoms, patients need to be hospitalized and may require artificial breathing support. Examples of emergency symptoms of Guillain-Barré syndrome include difficulty breathing, fainting, problems swallowing, drooling and temporary cessation of breathing. The Merck Manual Home Edition noted that “multiple sclerosis may progress and regress unpredictably.” For example, patients who have primary progressive pattern of multiple sclerosis have a gradual progression of the disease without periods of relapse or remission; however, patients with primary progressive pattern of multiple sclerosis may have temporary plateaus in which the disease does not get any worse. Patients have symptoms during episodes, which can last for days to months. When patients are not having episodes, they experience periods in which they have reduced symptoms or an absence of symptoms. The symptoms that a patient with multiple sclerosis experienced depends on the nerve fibers affected by the demyelination. For example, if the sensory nerve fibers become affected, patients can have numbness and tingling.
No cure exists for either Guillain-Barré syndrome or multiple sclerosis. Treatment for Guillain-Barré syndrome include removing the antibodies that attack the nerve cells, which can be done with plasmapheresis or immunoglobin therapy. Multiple sclerosis patients may take medications that slow the progression of the disorder, such as interferons. The NINDS pointed out that Guillain-Barré syndrome can be devastating for patients as the symptoms have a sudden onset; around 30 percent of patients have residual weakness three years post onset and around 3 percent have a muscle weakness relapse. While multiple sclerosis is a chronic disorder, MedlinePlus noted that life expectancy can be either normal or almost normal. Patients can suffer from varying degrees of disability, which depend on the frequency of the attacks and their severity, as well as the region of the CNS affected by the demyelination.
Merck Manual Home Edition: Multiple Sclerosis (MS)
NINDS: Guillain-Barré Syndrome Fact Sheet
MedlinePlus Medical Encyclopedia: Guillain-Barré Syndrome
MedlinePlus Medical Encyclopedia: Multiple Sclerosis
Dartmouth Medical School: Demyelinating Diseases of the Nervous System