Condition 101 About Guillain-Barre Syndrome

What is the definition of Guillain-Barre Syndrome?

Guillain-Barré syndrome (GBS) is a serious health problem that occurs when the body's defense (immune) system mistakenly attacks part of the peripheral nervous system. This leads to nerve inflammation that causes muscle weakness or paralysis and other symptoms.

What are the alternative names for Guillain-Barre Syndrome?

GBS; Landry-Guillain-Barré syndrome; Acute idiopathic polyneuritis; Infectious polyneuritis; Acute inflammatory polyneuropathy; Acute inflammatory demyelinating polyradiculoneuropathy; Ascending paralysis

What are the causes for Guillain-Barre Syndrome?

The exact cause of GBS is unknown. It is thought that GBS is an autoimmune disorder. With an autoimmune disorder, the body's immune system attacks itself by mistake. GBS can occur at any age. It is most common in people between ages 30 and 50.

GBS may occur with infections from viruses or bacteria, such as:

  • Influenza
  • Some gastrointestinal illnesses
  • Mycoplasma pneumonia
  • HIV, the virus that causes HIV/AIDS (very rare)
  • Herpes simplex
  • Mononucleosis

GBS may also occur with other medical conditions, such as:

  • Systemic lupus erythematosus
  • Hodgkin disease
  • After surgery

GBS damages parts of nerves. This nerve damage causes tingling, muscle weakness, loss of balance, and paralysis. GBS most often affects the nerve covering (myelin sheath). This damage is called demyelination. It causes nerve signals to move more slowly. Damage to other parts of the nerve can cause the nerve to stop working.

What are the symptoms for Guillain-Barre Syndrome?

Symptoms of GBS can get worse quickly. It may take only a few hours for the most severe symptoms to appear. But weakness that increases over several days is also common.

Muscle weakness or loss of muscle function (paralysis) affects both sides of the body. In most cases, the muscle weakness starts in the legs and spreads to the arms. This is called ascending paralysis.

If the inflammation affects the nerves of the chest and diaphragm (the large muscle under your lungs that helps you breathe) and those muscles are weak, you may need breathing assistance.

Other typical signs and symptoms of GBS include:

  • Loss of tendon reflexes in the arms and legs
  • Tingling or numbness (mild loss of sensation)
  • Muscle tenderness or pain (may be a cramp-like pain)
  • Uncoordinated movement (cannot walk without help)
  • Low blood pressure or poor blood pressure control
  • Abnormal heart rate

Other symptoms may include:

  • Blurred vision and double vision
  • Clumsiness and falling
  • Difficulty moving face muscles
  • Muscle contractions
  • Feeling the heart beat (palpitations)

Emergency symptoms (seek medical help right away):

  • Breathing temporarily stops
  • Cannot take a deep breath
  • Difficulty breathing
  • Difficulty swallowing
  • Drooling
  • Fainting
  • Feeling light headed when standing

What are the current treatments for Guillain-Barre Syndrome?

There is no cure for GBS. Treatment is aimed at reducing symptoms, treating complications, and speeding up recovery.

In the early stages of the illness, a treatment called apheresis or plasmapheresis may be given. It involves removing or blocking the proteins, called antibodies, which attack the nerve cells. Another treatment is intravenous immunoglobulin (IVIg). Both treatments lead to faster improvement, and both are equally effective. But there is no advantage to using both treatments at the same time. Other treatments help reduce inflammation.

When symptoms are severe, treatment in the hospital will be needed. Breathing support will likely be given.

Other treatments in the hospital focus on preventing complications. These may include:

  • Blood thinners to prevent blood clots
  • Breathing support or a breathing tube and ventilator, if the diaphragm is weak
  • Pain medicines or other medicines to treat pain
  • Proper body positioning or a feeding tube to prevent choking during feeding, if the muscles used for swallowing are weak
  • Physical therapy to help keep joints and muscles healthy

What are the support groups for Guillain-Barre Syndrome?

These resources may provide more information about GBS:

  • Guillain-Barré Syndrome Foundation International -- www.gbs-cidp.org
  • National Organization for Rare Disorders -- rarediseases.org/rare-diseases/guillain-barre-syndrome

What is the outlook (prognosis) for Guillain-Barre Syndrome?

Recovery can take weeks, months, or years. Most people survive and recover completely. In some people, mild weakness may persist. The outcome is likely to be good when the symptoms go away within 3 weeks after they first started.

Possible complications of GBS include:

  • Breathing difficulty (respiratory failure)
  • Shortening of tissues in the joints (contractures) or other deformities
  • Blood clots (deep vein thrombosis) that form when the person with GBS is inactive or has to stay in bed
  • Increased risk of infections
  • Low or unstable blood pressure
  • Paralysis that is permanent
  • Pneumonia
  • Skin damage (ulcers)
  • Breathing food or fluids into the lungs

When should I contact a medical professional for Guillain-Barre Syndrome?

Seek medical help right away if you have any of these symptoms:

  • Trouble taking a deep breath
  • Decreased feeling (sensation)
  • Difficulty breathing
  • Difficulty swallowing
  • Fainting
  • Loss of strength in the legs that gets worse over time
Superficial
Nerve
Brain

REFERENCES

Chang CWJ. Myasthenia gravis and Guillain-Barré syndrome. In: Parrillo JE, Dellinger RP, eds. Critical Care Medicine: Principles of Diagnosis and Management in the Adult. 5th ed. Philadelphia, PA: Elsevier; 2019:chap 61.

Katirji B. Disorders of peripheral nerves. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 107.

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Latest Advances On Guillain-Barre Syndrome

  • Condition: Cancer
  • Journal: Frontiers in immunology
  • Treatment Used: PD-1/PD-L1 Inhibitors
  • Number of Patients: 0
  • Published —
This meta-analysis evaluated the relationship between PD-1/PD-L1 inhibitors and neurological toxicities among cancer patients.
  • Condition: Miller Fisher Syndrome
  • Journal: South Dakota medicine : the journal of the South Dakota State Medical Association
  • Treatment Used: Intravenous Immunoglobulin (IVIg)
  • Number of Patients: 1
  • Published —
This case report describes a patient with Miller Fisher syndrome.

Clinical Trials For Guillain-Barre Syndrome

Clinical Trial
  • Status: Not yet recruiting
  • Phase: N/A
  • Intervention Type: Other
  • Participants: 50
  • Start Date: November 2021
Efficacy of Mini-pool Intravenous Immunoglobulin (MP-IVIG) Prepared by Assiut University Hospital Blood Bank in Guillain-Barré Syndrome