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Guillain-Barré syndrome

Guillain-Barré syndrome (GBS) is a disorder in which the body's immune system attacks part of the peripheral nervous system. The first symptoms of the disorder include weakness or tingling sensations in the legs. In many instances the symmetrical weakness and abnormal sensations spread to the arms and upper body.

These symptoms can increase in intensity until certain muscles cannot be used at all and, when severe, the person is almost totally paralyzed. In these cases the disorder is life threatening – potentially interfering with breathing and, in some cases, with blood pressure or heart rate – and is considered a medical emergency.

Guillain-Barré syndrome can affect anyone. It can strike at any age and both sexes are equally prone to the disorder. The syndrome is rare, however, affecting only about one person in 100,000.

Usually, Guillain-Barré occurs a few days or weeks after the patient has had symptoms of a respiratory or gastrointestinal viral infection. Occasionally, surgery will trigger the syndrome. In rare instances vaccinations may increase the risk of GBS.

Most patients recover from even the most severe cases of Guillain-Barré syndrome, although some continue to have weakness.

Common Symptoms

  • Weakness or tingling sensations in the legs
  • Spread of weakness and abnormal sensations to the arms and upper body
  • Eventual inability to use muscles
  • Paralysis in severe cases


After the first manifestations of the disease, symptoms can progress over the course of hours, days or weeks. Most people reach the stage of greatest weakness within the first two weeks after symptoms appear, and by the third week of the illness 90 percent of all patients are at their weakest.

Diagnosis

Guillain-Barré is called a syndrome rather than a disease because it is not clear that a specific disease-causing agent is involved. A syndrome is a medical condition characterized by a collection of symptoms (what the patient feels) and signs (what a doctor can observe or measure). The signs and symptoms of the syndrome can vary, so Guillain-Barré can be challenging to diagnose in its earliest stages.

Because several disorders have symptoms similar to those of Guillain-Barré, your doctor will examine and question you carefully before making a diagnosis. The signs and symptoms of Guillain-Barré form a certain pattern that helps doctors differentiate the syndrome from other disorders.

For example, your doctor will note whether the symptoms appear on both sides of the body (most common in Guillain-Barré) and the quickness with which the symptoms appear. In other disorders, muscle weakness may progress over months rather than days or weeks. In Guillain-Barré, reflexes such as knee jerks are usually lost.

Because the signals traveling along the nerves are slower in patients with the syndrome, your doctor may order a nerve conduction velocity (NCV) test for clues to aid in diagnosis, or a lumbar puncture in which a small amount of cerebrospinal fluid is taken from the spinal column using a needle.

Treatment

There is no known cure for Guillain-Barré syndrome, but there are therapies that lessen the severity of the illness and speed recovery in most patients. There are also a number of ways to treat complications of the disease.

Treatment involves keeping the patient's body functioning during recovery of the nervous system. This can sometimes require placing the patient on a ventilator, a heart monitor or other machines that assist body function.

Plasma exchange (also called plasmapheresis) and high-dose immunoglobulin therapy are used to treat the syndrome. Doctors still don't know exactly why plasma exchange works, but the technique seems to reduce the severity and duration of Guillain-Barré.

Giving high doses of immunoglobulins, derived from a pool of thousands of normal donors, to Guillain-Barré patients can lessen the immune attack on the nervous system.

Later, patients begin to recover limb control, physical therapy begins.

Source: National Institute of Neurological Disorders and Stroke


For More Information

GBS/CIDP Foundation International
National Institute of Neurological Disorders and Stroke

Stroke Aware
Neuroscience - In The News