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Guillain-Barre Syndrome

What is Guillain-Barré syndrome?

Guillain-Barré syndrome (GBS) is a neurological disorder in which the body's immune system attacks the peripheral nervous system. This is the part of the nervous system outside the brain and spinal cord. The onset of GBS can be quite sudden and unexpected and requires immediate hospitalization. It can develop over a few days, or it may take up to several weeks with the greatest weakness occurring within the first couple of weeks after symptoms appear.

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GBS is rare, affecting about 3,000 people in the U.S. It can affect people at any age and both men and women equally. GBS often develops following a respiratory or gastrointestinal viral infection.

What causes Guillain-Barré syndrome?

It’s not clear why some people get GBS. What is known is that the body's immune system begins to attack the body itself.

Normally, the cells of the immune system attack only foreign material and invading organisms, but in GBS, the immune system starts to destroy the myelin sheath that surrounds the axons of many nerve cells, and, sometimes, the axons themselves.

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When this occurs, the nerves can’t send signals efficiently, the muscles lose their ability to respond to the commands of the brain, and the brain receives fewer sensory signals from the rest of the body. The result is an inability to feel heat, pain, and other sensations.

GBS can occur after a viral infection, surgery, injury, or a reaction to an immunization.

What are the symptoms of Guillain-Barré syndrome?

The following are the most common symptoms of GBS. However, each person may experience symptoms differently.

The first symptoms include varying degrees of weakness or tingling sensations in the legs, which, sometimes, spreads to the arms and upper body. The symptoms may increase in severity. In some cases the muscles can’t be used at all, you become paralyzed, breathing is difficult, and blood pressure and heart function are affected. This is a medical emergency.

Although symptoms can become life-threatening, partial recovery is possible from even the most severe cases of GBS. However, you may always have some degree of weakness.

The symptoms of GBS may resemble other medical conditions or problems. Always consult your health care provider for a diagnosis.

How is Guillain-Barré syndrome diagnosed?

The signs and symptoms of GBS vary and can be difficult to diagnose in its earliest stages.

These signs and symptoms are unique to GBS:

  • Symptoms appear on both sides of the body.
  • Symptoms appear quickly--days or weeks as opposed to months.
  • Reflexes are usually lost.
  • High protein level in cerebral spinal fluid (this is the fluid that surrounds the spinal cord and brain)

To diagnose GBS, you may have the following tests:

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  • Spinal tap (also called a lumbar puncture). A special needle is placed into the lower back, into the spinal canal. This is the area around the spinal cord. The pressure in the spinal canal and brain can then be measured. A small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to determine if there is an infection or other problems.
  • Electrodiagnostic tests, such as electromyography (EMG) and nerve conduction velocity (NCV). These studies are done to evaluate and diagnose disorders of the muscles and motor neurons. Electrodes are inserted into the muscle, or placed on the skin overlying a muscle or muscle group, and electrical activity and muscle response are recorded.

How is Guillain-Barré syndrome treated?

Specific treatment for GBS will be determined by your health care provider based on:

  • Your age, overall health, and medical history
  • Extent of the syndrome
  • Your tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the syndrome
  • Your opinion or preference

There is no known cure for GBS. The goal of treatment is to prevent breathing problems and relieve symptoms. You will need to be hospitalized for treatment. Medications are used to control pain and other conditions that may be present. In addition, treatments, such as plasmapheresis or immunoglobulin administration, may be used to suppress the immune system and reduce inflammation caused by the immune system’s response to the disease.

  • Plasmapheresis is a procedure that removes the plasma (liquid part of the blood) and replaces it with other fluids. Antibodies are also removed with the plasma, which is thought to help reduce the symptoms of the disease.
  • Immunoglobulin is a blood product that helps to decrease the immune system’s attack on the nervous system.

Other therapies include hormonal therapy and physical therapy (to increase muscle flexibility and strength).

Through research, new treatments for GBS are continually being identified.

Key points

  • Guillain-Barré syndrome (GBS) is a neurological disorder in which the body's immune system attacks part of the peripheral nervous system.
  • The onset can be quite sudden and unexpected and requires immediate hospitalization.
  • The first symptoms include varying degrees of weakness or tingling sensations in the legs, which, sometimes, spreads to the arms and upper body.
  • The goal of treatment is to prevent breathing problems and relieve symptoms.
  • Recovery can be lengthy and residual muscle weakness or paralysis can occur.

Next steps

Tips to help you get the most from a visit to your health care provider:

  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.
Online Medical Reviewer: Foster, Sara, RN, MPH
Online Medical Reviewer: Freeborn, Donna, PhD, CNM, FNP
Date Last Reviewed: 1/14/2014
© 2000-2016 The StayWell Company, LLC. 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.