Former Florida Gators quarterback Danny Wuerffel has earned a national championship, won the Heisman Trophy, and spent six seasons in the NFL, but none of these accomplishments will be as hard-fought as recovery from Guillain-Barre Syndrome (GBS). Although his overall prognosis is good, Wuerffel still faces obstacles in the coming months as he rehabilitates from a disease that, for some, may result in long-term disability or paralysis.
Reports that Wuerffel contracted a "stomach bug" while on a retreat in Colorado, followed a week later by weakness and numbness in the hands and arms, is textbook for how GBS most commonly begins.
In about 60 percent of cases, the onset of the syndrome, which affects approximately one in 100,000 people, takes place approximately 1-3 weeks following a viral or bacterial infection. In patients who develop GBS, the body's immune system - which usually fights outside viruses and bacteria - instead destroys the protective covering (myelin sheath) of their own nerves. This disrupts electrical signaling to the muscles, causing weakness, numbness or paralysis.
Typically, the lower limbs are affected before the upper limbs, with the muscle deficits progressing in an ascending manner up the body over time. Muscle deficits develop acutely and progress over days to weeks, and severity may range from mild weakness to complete paralysis of all four limbs to loss of function of the breathing muscles in approximately one-third of patients,. These deficits are most severe approximately four weeks after the initial development of symptoms.
Because of the speed with which the condition progresses, and most importantly because mechanical ventilatory support would be required if the respiratory muscles are affected, any patient with symptoms of GBS requires immediate hospitalization for observation. Patients are also at risk for rapid changes in blood pressure, irregular heartbeats, and severe pain, all of which are best monitored in a hospital as well. Although there is no indication that Wuerffel has faced or runs the risk of any such complications, these may result in death in up to 10 percent of patients.
Although patients with the most severe symptoms may receive treatments such as plasmaphresis (filtration of the plasma portion of one's own blood) or intravenous immunoglobulins (antibodies donated from another's blood), most patients recover spontaneously. Whether treatments are required or not, the road to full recovery may take 6-12 months or more, with the typical rehabilitation process including intensive physical therapy and conditioning.
In total, 70-80 percent of those who dedicate themselves to the demanding rehab process experience a complete recovery, with age being the most important prognostic factor overall: children and the elderly are far more likely to experience permanent deficits than young adults.
While he is still relatively early in the course of the disease, with symptoms likely to worsen over the next weeks, Wuerffel's prognosis for recovery from GBS is quite good. How far he makes it back to his prior state of well-being, however, will be a test of the work ethic that made him a legend at Florida.