Anaheim Ducks winger Patrick Eaves who was diagnosed with a relatively rare disease called Guillain-Barré syndrome (GBS) that may not only impact his future career in hockey but also his life. The 33-year-old last played on October 13 before he was admitted to Hoag Hospital in Orange County, CA with this very scary condition. Basically, GBS causes the body’s immune system to attack it’s peripheral nervous system.
Guillain-Barré syndrome (GBS) presents is an acute paralyzing illness caused by an infection. The most common cause is a bacteria called Campylobacter jejuni, but also can be caused by Cytomegalovirus, Epstein-Barr virus, HIV, and Zika virus. It is unclear how and from what specific source that Eaves contracted the GBS. Campylobacter jejuni is actually a quite common infection in the United States, causing over 1.3 million illnesses annually. The most common cause reason to get this infection is due to eating raw or undercooked poultry, or at least something that may have touched it. Other possibilities include contaminated water, contact with animals or drinking raw unpasteurized milk.
The important thing is that Eaves’ medical team caught his concerning condition early enough, and quick action lead to a stay in the hospital’s intensive care unit (ICU). Eaves initially presented with physical weakness – which is classically how GBS starts, often in the legs. Another scary feature of Guillain-Barré is that there can be severe paralysis of the respiratory muscles, sometimes requiring ventilatory support (in approximately 10 to 30% of patients). About 50% of patients with GBS suffer from facial nerve palsies, like drooping of the lip, and 50% suffer from oropharyngeal weakness – all very scary. Additionally, these patients suffer from a significant amount of pain, often in their hands, feet and back.
Guillain-Barre syndrome is quite rare; it has a worldwide incidence of 1 to 2 cases per 100,000 per year. All age groups are affected, with a slightly higher incidence in males than females.
There are two different treatment options: plasma exchange, also known as plasmapheresis, and the administration of intravenous immune globulin (IVIG). Plasmapheresis works by removing circulating antibodies that are responsible for all of the various Guillain-Barré symptoms. The use of IVIG in GBS is less clear, the theory is that there are antibodies that interact with all of the different cells and receptors that were activated and are responsible for the symptoms (yes it’s very confusing).
Ideally, these treatments should start within four weeks of symptom onset. The choice between plasmapheresis and IVIG ultimately depends on local availability, patient preference, risk factors, and contraindications. While I have personally ordered each of these options during residency in the care of my patients, it was few and far between, as I like to consider them the last resort.
The good news is that this scary disease was identified and caught quite early, and it sounds like Eaves is on the correct treatment path. The use of (either of) these two treatments shortens the recovery time by approximately 50%. Approximately 84% of patients with Guillain-Barré walk independently at one year after diagnosis. At one year, 60% of patients have full recovery of motor strength, while 14% have persistent severe motor issues.
We often take things in life for granted. One minute Eaves was racing down the ice playing in a hockey game, the next minute he’s laying in an ICU bed fighting to move his legs, all due to an infection he didn’t even know he acquired. Crazy. Life is so precious. I wish him the best of luck on his long road to recovery, and hope that one day soon he will be able to lace up his skates again and get back out on the ice.
Information about the Author:
This was written by Dr. Jesse Morse. Dr. Morse is a Board-Certified Family Medicine physician, who is currently completing a Sports Medicine Fellowship at the University of South Florida in Tampa. Dr. Morse covers many teams, and is part of the medical staff that covers the Spring Training for the Philadelphia Phillies and the Toronto Blue Jays. This information should be used for entertainment only, and not for medical advice. If you have any questions or comments, you can contact me directly at @DrJesseMorse or visit my website at: www.DrJesseMorse.com.
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