Guillain-Barré syndrome

What is Guillain-Barré syndrome?

Guillain-Barré syndrome is a rare neurological disorder. It can occur at any age, but it most commonly affects people between the ages of 30 and 50. The disorder is when the immune system attacks the peripheral nerves. The result is often:

  • Numbness
  • Tingling
  • Muscle weakness

Experiencing muscle weakness can advance to paralysis, but there are treatment options to allow for a full recovery. Approximately 100,000 people worldwide develop Guillain-Barré syndrome each year.

What are symptoms of Guillain-Barré syndrome?

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Tingling and weakness in the feet and legs are often the first symptoms of Guillain-Barré syndrome. The sensations can eventually spread to the upper body and arms, but it also originates sometimes in the arms or face. Other symptoms may include:

  • Pins and needles in the fingers, toes, ankles, or wrists
  • Unsteadiness or difficulty walking
  • Struggling to climb stairs
  • Leg weakness that spreads to the upper extremities
  • Double vision
  • Inability to move the eyes
  • Trouble speaking, chewing, or swallowing
  • Severe pain (achy, shooting, or cramplike) that may worsen at night
  • Rapid heart rate
  • Low or high blood pressure
  • Trouble with bladder control or bowel function
  • Difficulty breathing

 

The most significant weakness associated with Guillain-Barré syndrome is typically felt within two weeks of the onset or symptoms. Contacting your healthcare provider once you notice a new symptom is advised.

For medical emergencies involving yourself or a loved one, immediately call 911 for assistance.

When should you see a doctor about Guillain-Barré syndrome?

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Reaching out to a healthcare professional once you notice mild tingling in your toes or fingers can help you receive treatment before the condition spreads or worsens. Call 911 if you start experiencing more serious symptoms, like:

  • Tingling that moves up your body or spreads quickly
  • Choking on saliva
  • Shortness of breath when lying flat

 

Guillain-Barré syndrome can progress quickly if left untreated. Starting treatment early will improve the likelihood of achieving a complete recovery.

What are the types of Guillain-Barré syndrome?

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A person’s type of Guillain-Barré syndrome often dictates the symptoms that they experience. There are several main types that are most prevalent in different regions of the world.

 

Acute Inflammatory Demyelinating Polyradiculoneuropathy

  • Most common in North America and Europe
  • Characterized by muscle weakness
  • AIDP starts in the lower part of the body and moves upward

 

Miller Fisher Syndrome

  • Paralysis starts in the eyes
  • Characterized by unsteadiness while walking
  • MFS is less common in the U.S. and more common in Asia

 

Acute Motor Axonal Neuropathy and Acute Motor-Sensory Axonal Neuropathy

  • Less common in the U.S.
  • AMAN and AMSAN cases often occur in China, Japan, and Mexico

 

Speaking directly with a healthcare provider is the best way to receive an accurate diagnosis for Guillain-Barré syndrome.

How is Guillain-Barré syndrome diagnosed?

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The neurological disorder is sometimes difficult to diagnose in its earliest stages. The symptoms may appear like those of other conditions and often vary between different people. A healthcare provider will ask for your medical history and conduct a thorough physical examination.

A healthcare professional may recommend:

  • A spinal tap (lumbar puncture): Drawing a small amount of fluid from the spinal canal in your lower back to test for changes associated with GBS.
  • Nerve conduction studies: Taping electrodes to the skin above the nerves to measure the speed of nerve signals.

 

Sharing your full medical history, or as much as possible, with your doctor will allow a healthcare provider to determine the best diagnostic course of action.

What are common causes of Guillain-Barré syndrome?

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The exact cause(s) of Guillain-Barré syndrome remain unknown. There are certain common and rare triggers for the disorder, including:

  • Appearing days or weeks after a respiratory or digestive tract infection (common)
  • Recent surgery (rare)
  • Recent vaccination (rare)

 

Other potential triggers for Guillain-Barré syndrome are:

 

  • Influenza virus
  • Trauma
  • Hepatitis A, B, C, and E
  • HIV
  • Hodgkin lymphoma
  • Cytomegalovirus
  • Zika virus
  • Epstein-Barr virus
  • Mycoplasma pneumonia
  • COVID-19 virus

Are there Guillain-Barré syndrome risk factors?

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Anyone can develop Guillain-Barré syndrome, but certain higher-risk groups include:

  • Older adults
  • Men more than women

What are Guillain-Barré syndrome complications?

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People living with Guillain-Barré syndrome may experience longer-lasting complications like:

  • Residual numbness or other sensations
  • Irregular heart rhythms
  • Blood pressure fluctuations
  • Nerve pain (can be eased with medicine)
  • Urine retention and slower bowel function
  • Pressure/bed sores (can be eased by changing your position)
  • Blood clots caused by immobility (blood thinners and support stockings may help)
  • Trouble breathing (using a machine while hospitalized can help in the first week)
  • A relapse, causing muscle weakness years after symptoms disappeared

 

The risk of developing serious long-term complications increases when earlier symptoms are more severe. There are rare instances where respiratory distress syndrome or a heart attack can result in death. Speaking to a healthcare provider can significantly reduce these or other long-term concerns.

How is Guillain-Barré syndrome treated?

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There is currently no cure for Guillain-Barré syndrome, but certain therapies can shorten the recovery time and lessen any painful symptoms. The common treatments for Guillain-Barré syndrome are:

  • Plasma exchange (plasmapheresis), which filters out the antibodies within a person’s plasma that attack the nerves before returning the plasma and blood to the body.
  • Intravenous immunoglobulin therapy (IVIG), which can reduce the immune system’s attack on a person’s nerves.

 

The most effective method for either treatment occurs when you start one within two weeks of your earliest GBS symptoms.

Patients who had GBS and need treatment for complications may undergo:

  • Respiratory care (possibly mechanical ventilation)
  • Blood clot prevention (with a prescribed anticoagulant)
  • IV fluids and tube feeding (to prevent dehydration, malnutrition, or aspiration pneumonia)

 

There are also rehabilitation treatments that a healthcare team might recommend for once you leave the hospital. Receiving specialized therapy treatment can help patients to regain their full strength and resume activities that are part of their daily lives. Types of therapy include:

  • Physical therapy (for pain management and regaining muscle strength)
  • Occupational therapy (to improve daily tasks like standing, sitting, and moving)
  • Speech therapy (to regain the ability to swallow and speak)
  • Mobility aids (adapting to canes, braces, walkers, and wheelchairs)

 

The best treatment plan takes multiple factors into account, including each person’s medical history. Speaking with a doctor about which option or combination of treatments will be best suited for your recovery is the key to regaining greater independence.

Is Guillain-Barré syndrome preventable?

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Guillain-Barré syndrome is not preventable in most cases. You can try to reduce the risk of developing GBS by practicing healthy living habits, including:

  • Routinely washing your hands
  • Avoiding direct contact with people who have the stomach flu or infections
  • Eating healthy to boost your immune system
  • Regularly exercising
  • Disinfecting surfaces (tables, countertops, toys, handles, phones, bathroom fixtures)
  • Staying up-to-date with vaccines

What is the outlook for Guillain-Barré syndrome?

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Most people with Guillain-Barré syndrome make considerable improvements after anywhere from six to 12 months of recovery. Recovery can take up to three years for some individuals. About 30% of adults, and more children, have residual muscle weakness three years after a GBS diagnosis.

An early timeline may look like:

  • Worsening condition for about two weeks after the first symptoms
  • Symptoms plateau within four weeks (a month)

 

Although adults recover from Guillain-Barré syndrome with unique timelines, there are certain common milestones throughout the recovery process.

  • Six months after diagnosis: About 80% can walk without assistance
  • One year after diagnosis: About 60% fully recover motor strength

 

In the rare cases of children who develop Guillain-Barré syndrome, they typically recover more completely than adults. There are about 5-10% of causes where people have a delayed and an incomplete recovery.

Getting an accurate recovery outlook is possible when you speak to your doctor about concerns or questions that you might have regarding your treatment.

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