Guillain-Barré Syndrome

Topic Overview

What is Guillain-Barré syndrome (GBS)?

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.

What causes Guillain-Barré syndrome?

Experts don't know what causes GBS. They think that the nerves are attacked by your body’s own defense system (the immune system). This is called an autoimmune disease.

In GBS, the immune system attacks the covering (myelin sheath ) of certain nerves. This causes nerve damage.

What infections may trigger Guillain-Barré syndrome?

GBS usually begins to affect the nerves after you've had a viral or bacterial infection. Often it is after an infection of the lungs or stomach and intestines.

Infections that may trigger GBS include:

• Campylobacter jejuni, which can cause a type of food poisoning.
• Mycoplasma, which can cause pneumonia.
• Cytomegalovirus (CMV), which can cause fever, chills, sore throat, swollen glands, body aches, and fatigue.
• Epstein-Barr virus (EBV), which can cause mononucleosis (mono).
• Varicella-zoster virus, which can cause chickenpox and shingles.

What are the symptoms?

Symptoms of GBS include:

• Numbness or tingling in your hands and feet and sometimes around the mouth and lips.
• Muscle weakness in your legs and arms and the sides of your face.
• Trouble speaking, chewing, and swallowing.
• Not being able to move your eyes.
• Back pain.

Symptoms usually start with numbness or tingling in the fingers and toes. Over days to weeks, 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.

How is Guillain-Barré syndrome diagnosed?

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.

• Your arms and legs are getting weaker.
• You are losing your reflexes, which are automatic body movements that you can't control.

Your doctor also may do tests, such as a lumbar puncture and nerve conduction study.

If the diagnosis isn't clear, you may be referred to a doctor who specializes in the nervous system (neurologist).

How is it treated?

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.

In the hospital, you may get a plasma exchange or intravenous immune globulin (IVIG).

• In a plasma exchange, blood is taken out of your body. The harmful antibodies are removed from the blood, and then the blood is returned to your body.
• In IVIG, helpful antibodies are added to your blood.

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 physical 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:	What is Guillain-Barré syndrome? What are the symptoms?
Being diagnosed:	How is Guillain-Barré syndrome diagnosed?
Getting treatment:	How is Guillain-Barré syndrome treated? What is immunotherapy for GBS?
Living with Guillain-Barré syndrome:	What can I do at home to get stronger after GBS?

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Author:	Monica Rhodes	Last Updated: July 31, 2008
Medical Review:	Anne C. Poinier, MD - Internal Medicine Colin Chalk, MD, CM, FRCPC - Neurology
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