Guillain Barre Syndrome

Guillain-Barré [gee-YAN-buh-REY] syndrome is a rare condition that causes numbness and weakness. It happens when the immune system attacks and damages the lining of nerves. Most people who develop Guillain-Barré syndrome had an infection of some kind before their symptoms started, but for some, a trigger is never found. Most people recover from a Guillain-Barré episode, but some continue to have problems with muscle weakness.

Guillain-Barré syndrome is an autoimmune disorder. This means that the body’s immune (disease-fighting) system attacks its own body. With Guillain-Barré syndrome, the immune system attacks and damages the lining of nerves and the nerves themselves. It destroys the nerves’ protective cover (myelin sheath) and sometimes the nerves themselves.

Guillain-Barré affects nerves all over the body, causing muscle weakness and numbness. In some cases, the person cannot move any muscles and is paralyzed. It is dangerous when Guillain-Barré syndrome affects the chest muscles that allow a person to breathe. When this happens, a person must have a ventilator, a machine that helps a person breathe. Guillain-Barré syndrome can also lead to heart arrhythmias.

Guillain-Barré syndrome is rare. It affects only about 1 out of every 100,000 people. Most people recover from it well, but some continue to have weakness and numbness afterwards.

The main symptoms of Guillain-Barré syndrome are numbness and muscle weakness. These are mild at first but get worse over time. The first symptom is usually tingling or weakness in the legs. The arms, face, and other parts of the body then start to feel weak.

Most people with Guillain-Barré syndrome have the greatest weakness about 2 to 3 weeks after they get the first symptoms. In severe cases, the person will have partial or total paralysis. If Guillain-Barré affects the chest muscles, it may become difficult to breathe.

See a doctor as soon as you experience sudden tingling or muscle weakness. Because this is a serious illness, anyone with Guillain-Barré syndrome should be under the care of a doctor.

The cause of Guillain-Barré syndrome is not completely known. When it happens, it is usually after a person has a respiratory (nose, throat, chest) or gastrointestinal (stomach) illness. Guillain-Barré symptoms appear in the days and weeks after such an illness. For example, some people infected with the Zika virus experienced Guillain-Barré syndrome afterward.

An infection often starts Guillain-Barré syndrome, but other events that trigger the immune system can also cause Guillain-Barré. In rare cases, surgery or certain vaccines can trigger it. Researchers are still learning about why the immune system has this reaction. Often, the cause is not found.

A doctor may do one or many things to help diagnose Guillain-Barré syndrome, including:

• An exam. The doctor will check your symptoms and the muscle weakness. People with Guillain-Barré usually have weakness on both sides of the body instead of just one side. The weakness usually happens rather quickly, which is different from some other conditions in which muscle weakness develops slowly over months or years.
• Nerve conduction velocity (NCV) test. Your doctor may recommend this test to see if the nerves are working more slowly than usual. An NCV test can also show if the problem is with the nerve or the myelin sheath. To perform the test, two pads called electrodes are placed on your skin. One of these will send a brief and mild shock to the nerve. The other one will record the nerve activity that results. The test may be uncomfortable for just a minute or so, but does not usually hurt.
• Spinal tap. Your doctor may also recommend a spinal tap to look at the fluid that surrounds your spinal cord and brain. If you have Guillain-Barré syndrome, your spinal fluid may have more protein in it than normal. To do a spinal tap, a needle is inserted into the lower back to take a small amount of spinal fluid.

There is no cure for Guillain-Barré syndrome. Most people recover on their own, but recovery can take anywhere from a few weeks to a few years. About 1 out of 3 people who get Guillain-Barré have some remaining muscle weakness even after 3 years.

A number of treatments can help to keep your body working properly during recovery, including:

• Plasma exchange. With this treatment, blood is taken out of the body and the plasma, a part of the blood, is removed. Then, the blood is put back into the body without plasma. This may lessen your body’s reaction to Guillain-Barré and help you recover faster.
• High-dose immunoglobulin therapy. Certain proteins are injected into the blood to help stop the immune system from attacking the nerves.
• Ventilator and other supports. Depending on what parts of the body are affected, you may get help with breathing or other treatments to stay safe during the episode.

There is no known way to prevent Guillain-Barré syndrome. But it is a relatively rare condition that affects only about 1 out of every 100,000 people.

National Institute of Neurological Disorders and Stroke

World Health Organization