Guillain-Barré syndrome (say "ghee-YAN bah-RAY") is a problem with your nervous system. It causes muscle weakness, loss of reflexes, and numbness or tingling in your arms, legs, face, and other parts of your body.
Guillain-Barré syndrome (GBS) can cause paralysis and lead to death. But most people get better and have few lasting problems.
GBS is rare.
In GBS, the immune system attacks the covering (myelin sheath) of certain nerves. This causes nerve damage.
Infections that may trigger GBS include:
Symptoms of GBS include:
Symptoms usually start with numbness or tingling in the fingers and toes. Over several days, muscle weakness in the legs and arms develops. After about 4 weeks, most people begin to get better.
You may need to be treated in the hospital for the first few weeks. This is because GBS can be deadly if weakness spreads to muscles that control breathing, heart rate, and blood pressure.
Call your doctor or get help right away if you think you might have GBS.
Your doctor will ask when your symptoms started and how they have changed. He or she also may ask if you've had any recent infections.
Two signs are important in helping your doctor decide if you have GBS.
If the diagnosis isn't clear, you may be referred to a doctor who specializes in the nervous system (neurologist).
GBS usually is treated in the hospital. The hospital staff will watch you carefully to be sure you don't get worse or get an infection. Your breathing, heart rate, and blood pressure are carefully tracked. Some people need a ventilator to help them breathe.
These treatments may help your body fight the disease and may speed your recovery if they are used when you first get GBS.
You may need 3 to 6 months or longer to recover from GBS. And sometimes GBS can come back.
If you had severe muscle weakness, you may need physiotherapy or occupational therapy. You will also need exercise to help you regain muscle strength and movement. You may need help with daily tasks for a while.
Frequently Asked Questions
Learning about Guillain-Barré syndrome:
Living with Guillain-Barré syndrome:
Symptoms of Guillain-Barré syndrome (GBS) include:
The first symptoms of Guillain-Barré syndrome include tingling in the fingers and toes and weakness in the arms and legs that may appear several days or weeks after a respiratory or gastrointestinal infection. Tingling is a very common symptom that may be caused by a wide variety of medical problems. But after muscle weakness develops in addition to tingling, GBS becomes a more likely cause of these symptoms. Tingling and weakness may spread to the arms and upper body. GBS can become life-threatening if weakness spreads to muscles that control breathing, heart rate, and blood pressure.
Muscle weakness caused by GBS often gets worse over 1 to 4 weeks before it stabilizes and then gradually improves. In some people, symptoms continue to get worse for up to 3 months.
There are different forms of GBS, but symptoms are often a lot alike. Most GBS symptoms are caused by damage to nerve coverings (demyelination). This causes problems with how messages travel between the brain and the rest of the body.
Guillain-Barré syndrome (GBS) may be hard to diagnose in the early stages of the disease. A detailed examination of your nervous system is needed to diagnose the condition. Your doctor will ask questions about your symptoms, including when they started and how they have changed over time. A history of recent infection (especially respiratory or gastrointestinal illness) may also have important clues for the diagnosis.
The two signs that must be present to diagnose GBS are:
When these two signs are present, a diagnosis of GBS may be more likely if:
Some tests may be needed to rule out other conditions, such as electrolyte imbalances and certain types of poisoning, that could also be causing the symptoms and to help confirm the diagnosis of GBS. These tests include:
In the very early stages of GBS, the results of these tests may be normal. Abnormal results may not show up for a week or more after symptoms begin.
If the diagnosis is unclear, you may be referred to a doctor who specializes in brain and nervous system disorders (neurologist).
The main treatment for GBS is preventing and managing complications (such as breathing problems or infections) and providing supportive care until symptoms begin to improve. This may include:
Other treatment of Guillain-Barré syndrome (GBS) depends on how severe your symptoms are. More severe cases of GBS are treated with immunotherapy, which includes plasma exchange or intravenous immune globulin (IVIG). Treatment is given in a hospital. It starts immediately after you have been diagnosed with GBS that is getting worse. Early intervention with either of these treatments appears to be effective and may reduce recovery time. Neither treatment is better than the other, and there is no benefit to combining these treatments.2
Careful monitoring is very important during the early stages of GBS, because breathing problems and other life-threatening complications can occur within 24 hours after symptoms first start.
You probably will need to be hospitalized if you:
If possible, you will be referred to a medical centre that has experience treating the illness.
Recovery may take 3 to 6 months, sometimes longer—in some cases, up to 18 months. People who have severe muscle weakness may need to stay at a rehabilitation hospital to receive ongoing physiotherapy and occupational therapy as their motor function returns. For those who stay at home, devices that help perform certain daily activities can be used until motor function and muscle strength return.
Physiotherapy and regular exercise are needed throughout the recovery period to strengthen the weakened muscles. The therapy program can be made to fit your specific needs.
Although recovery can be slow, most people who have GBS eventually recover.
Relapses or repeated episodes of GBS happen in about 5 to 10 out of 100 cases, and they may be very serious.1 If you have a relapse, aggressive treatment with plasma exchange or IV immune globulin may reduce the severity of the attack and prevent further relapses. If you have more than one relapse, treatment with other drugs may be needed.
If you think you might have Guillain-Barré syndrome (GBS), call your doctor or seek immediate medical attention.
After having Guillain-Barré syndrome, you may have to wait several months before you can return to your regular daily activities. Support at home is important during this time. You may need temporary help with some of your activities and chores. Also, you can strengthen your weakened muscles by exercising regularly. Talk to your doctor about exercising during your recovery.
|U.S. National Institute of Neurological Disorders and Stroke|
|NIH Neurological Institute|
|P.O. Box 5801|
|Bethesda, MD 20824|
The U.S. National Institute of Neurological Disorders and Stroke (NINDS), a part of the U.S. National Institutes of Health, is the leading U.S. federal government agency supporting research on brain and nervous system disorders. It provides the public with educational materials and information about these disorders.
|Guillain-Barré Syndrome/Chronic Inflammatory Demyelinating Polyneuropathy Foundation International (GBS/CIDP)|
|104½ Forrest Avenue|
|Narberth, PA 19072|
This organization is a good source of information and support for people affected by Guillain-Barré syndrome (GBS) or Chronic Inflammatory Demyelinating Polyneuropathy (CIDP). It can direct people who have long-term disability caused by GBS or CIDP to support groups and resources that provide vocational, financial, and other assistance.
- Ropper AH, Samuels MA (2009). Guillain-Barré syndrome (Landry-Guillain-Barré-Strohl syndrome, acute inflammatory demyelinating polyneuropathy) section of Diseases of the peripheral nerves. In Adams and Victor's Principles of Neurology, 9th ed., pp. 1261–1270. New York: McGraw-Hill.
- Hughes RAC, et al. (2003). Practice parameter: Immunotherapy for Guillain-Barré syndrome. Neurology, 61: 736–740.
Other Works Consulted
- Hughes RAC, et al. (2006). Intravenous immunoglobulin for Guillain-Barré syndrome. Cochrane Database of Systematic Reviews (1). Oxford: Update Software.
- Raphaël JC, et al. (2002). Plasma exchange for Guillain-Barré syndrome. Cochrane Database of Systematic Reviews (2). Oxford: Update Software.
|Primary Medical Reviewer||Anne C. Poinier, MD - Internal Medicine|
|Specialist Medical Reviewer||Colin Chalk, MD, CM, FRCPC - Neurology|
|Last Revised||September 2, 2010|
Last Revised: April 2, 2012
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