Guillain-Barré Syndrome

Guillain-Barré syndrome (GBS) is a rare and serious neurological disease that affects the peripheral nerves, the nerves outside of your brain and spinal cord. With GBS, your immune system mistakenly attacks the nerves in your body. It’s named after the doctors who first identified it.

What are the symptoms of Guillain-Barré syndrome?

Since GBS affects your peripheral nerves, it can affect your muscles and sensations of pain or touch.

The condition usually starts with tingling and weakness in both legs that can get worse and spread to the arms and upper body. Sometimes, it starts in the hands and arms. In severe cases, it can cause paralysis or difficulty breathing and become a medical emergency. 

Other symptoms include:

• Difficulty with eye movements or double vision
• Trouble swallowing, speaking or chewing
• Severe cramping, shooting or aching pain
• Trouble walking or climbing stairs
• Bladder or bowel control issues
• Fast heart rate
• High or low blood pressure

Symptoms generally start suddenly and get worse quickly, over hours, days or weeks. For most people, symptoms get worse for about two weeks and level off, then slowly lessen. Recovery can take months or years.

What causes Guillain-Barré syndrome?

It’s not clear what causes GBS. It may develop when your body is trying to fight off a respiratory or digestive infection and mistakes your nerve cells for a virus or bacteria.

It’s possible to develop GBS several weeks after these viral or bacterial infections:

• Campylobacter jejuni: This bacterial infection often causes food poisoning and is the most common trigger of GBS, linked with about 30% of cases.
• Cytomegalovirus (CMV) and Epstein-Barr virus (EBV): These viruses may trigger an immune response that targets nerve tissue.
• Influenza (flu): Infections with influenza A and B are linked to some cases of GBS.
• Other causes: Viral infections like COVID-19, the Zika virus, hepatitis and HIV, as well as trauma or surgery, may also trigger GBS.

Rarely, you could develop Guillain-Barré syndrome from a vaccination such as the flu vaccine. However, the risk is very low - just one to two cases per million doses of vaccine. The benefits of vaccination far outweigh the risks. In fact, the risk of GBS may be higher from the flu than from the flu vaccine.

GBS can affect anyone of any age, but it is most common in men and adults over age 50. People with an autoimmune disease like lupus or rheumatoid arthritis may be at higher risk. You may also be more likely to develop the condition if others in your family have it. GBS is not contagious.

How is Guillain-Barré syndrome diagnosed?

If you have mild symptoms of GBS, it’s important to contact a health care provider for evaluation. Get emergency care for tingling that’s moving up your body, trouble breathing or shortness of breath when you’re lying down. You’re more likely to have a better outcome without complications if you start treatment quickly.

To diagnose GBS, your provider may perform these exams and tests:

• Physical examination: A check of your muscle strength, reflexes, coordination and sensation, looking for signs of muscle weakness or paralysis.
• Nerve conduction studies: These studies measure the electrical impulses in nerves and muscles. They are also known as electromyography (EMG) and nerve conduction velocity (NCV) tests. With GBS, it’s common to have slow nerve conduction and abnormal nerve responses. These tests help uncover where nerves are damaged and how severe the damage is. 
• Lumbar puncture (spinal tap): This procedure uses a needle inserted into the lower back to take a sample of cerebrospinal fluid (CSF). Having high protein levels in the fluid without an increase in white blood cells is a sign of GBS. This test helps determine whether you have GBS or another neurological condition.
• MRI: In some cases, an MRI of the brain or spine might be used to check for other causes of weakness.

Types of Guillain-Barré syndrome

The most common types of GBS are:

• Acute inflammatory demyelinating polyradiculoneuropathy (AIDP): This is the most common type in North America and Europe, with weakness that begins in the feet and legs and moves up in the body. It affects the protective cover of the nerves (the myelin sheath).
• Miller Fisher syndrome (MFS): This type is more common in Asia and less common in the U.S. With it, you may have paralysis that begins in the eyes and an unsteady walk.
• Acute motor axonal neuropathy (AMAN) and acute motor-sensory axonal neuropathy (AMSAN): These types are found more often in China, Japan and Mexico and less often in the U.S.

How is Guillain-Barré syndrome treated?

It’s important to be treated for GBS right away. It can’t be cured but treatment can make it less severe, shorten recovery time and reduce the risk of complications.

Most people with GBS need to stay in the hospital for monitoring, pain control, nutrition and treatment for any breathing problems. It’s common for people with GBS to stay in the intensive care unit (ICU). 

The main treatment options for GBS are:

• Intravenous immunoglobulin (IVIG) therapy: With it, you receive high doses of immunoglobulin, a mixture of antibodies from healthy donors, over several days. IVIG therapy helps reduce the immune system's attack on your nerves so you can recover. 
• Plasmapheresis (plasma exchange): Plasma exchange removes the harmful antibodies your body has created from the liquid part of the blood (plasma) and returns healthy plasma back to you. The exchange helps reduce the immune response causing nerve damage and can help make GBS shorter and less severe. 

You may also need:

• A breathing tube to support your breathing.
• Medication to prevent blood clots.
• IV fluids to prevent dehydration.
• A feeding tube if you can’t eat.

After GBS is treated you’ll probably need rehabilitation to help in your recovery:

• Physical therapy can help you regain muscle strength and coordination.
• Occupational therapy can help you perform daily activities.
• Speech therapy can help treat trouble with communication and swallowing. 
• Using a cane, walker, wheelchair or brace can help prevent falls and fatigue as you become more mobile.

It can be challenging to cope during recovery. You may also want to seek mental health counseling or join a support group for people with GBS.

Recovering from Guillain-Barré syndrome

While most people recover from GBS, timelines and outcomes vary. Most people recover in weeks to months, even if they have a severe case. People who become paralyzed are usually able to walk six months later.

Many people fully recover, but some have long-lasting weakness, numbness or fatigue. In rare cases, people need ongoing care, support and management for GBS.

Why choose Banner Brain & Spine?

Banner Brain & Spine is committed to providing quality care for people with complex neurological conditions like Guillain-Barré syndrome. Our specialists are experienced in managing GBS, so you receive the highest standard of care.

From advanced diagnostic tools to treatment plans that may include IVIG therapy, plasmapheresis and rehabilitation, our goal is to support your recovery. Our approach is centered around you, with every decision and treatment plan designed to meet your needs and preferences. 

For expert care and support in managing Guillain-Barre syndrome or other neurological conditions, reach out to a Banner Health provider.