Guillain-Barre syndrome is a serious health problem that occurs when the body's defense (immune) system mistakenly attacks part of the nervous system. This leads to nerve inflammation that causes muscle weakness or paralysis and other symptoms.
Guillain-Barre syndrome (GBS) is an autoimmune disorder. With an autoimmune disorder, the body's immune system attacks itself. The exact cause is unknown. GBS can occur at any age. It is most common in people of both sexes between ages 30 and 50.
GBS often follows a minor infection, such as a lung infection or gastrointestinal infection. Most of the time, signs of the infection have disappeared before the symptoms of GBS begin.
The swine flu vaccination in 1976 may have caused rare cases of GBS. The swine flu and the regular flu vaccines used today have not caused more cases of the illness.
GBS damages parts of nerves. This nerve damage causes tingling, muscle weakness, and paralysis. GBS most often affects the nerve's 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 altogether.
Severe illness (GBS of this type is called neuropathy of critical illness)
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 diaphragm and chest and there is weakness in those muscles, the person may need breathing assistance.
A history of increasing muscle weakness and paralysis may be a sign of GBS, especially if there was a recent illness.
A medical exam may show muscle weakness. There may also be problems with blood pressure and heart rate. These are functions that are controlled automatically by the nervous system. The examination may also show that reflexes such as the ankle or knee jerk are decreased or missing.
There may be signs of decreased breathing caused by paralysis of the breathing muscles.
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, treatment called apheresis or plasmapheresis may be given. This treatment involves removing or blocking the proteins, called antibodies, that attack the nerve cells. Other treatment helps reduce inflammation.
When symptoms are severe, treatment in the hospital will be needed. There, breathing support will likely be given.
Other treatments focus on preventing complications:
Blood thinners may be used to prevent blood clots.
If the diaphragm is weak, breathing support or even a breathing tube and ventilator may be needed.
Pain is treated with pain medicines or other medicines.
Proper body positioning or a feeding tube may be used to prevent choking during feeding if the muscles used for swallowing are weak.
Physical therapy helps keep joints and muscles healthy.
Recovery can take weeks, months, or years. Most people survive and recover completely. Mild weakness may persist for some people. Outcome is likely to be good when the symptoms go away within 3 weeks after they first started.
Breathing in food or fluids into the lungs (aspiration)
When to Contact a Medical Professional
Seek immediate medical help if you have any of the following symptoms:
Are unable to take a deep breath
Decreased feeling (sensation)
Loss of strength in the legs that gets worse over time
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Yuki N, Hartung HP. Guillain–Barre syndrome. N Engl J Med. 2012;366:2294-2304.
Luc Jasmin, MD, PhD, FRCS (C), FACS, Department of Neurosurgery at Cedars-Sinai Medical Center, Los Angeles CA; Department of Surgery at Los Robles Hospital, Thousand Oaks CA; Department of Surgery at Ashland Community Hospital, Ashland OR; Department of Surgery at Cheyenne Regional Medical Center, Cheyenne WY; Department of Anatomy at UCSF, San Francisco CA. Review provided by VeriMed Healthcare Network.