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, andblood pressure.
Guillain-Barré Syndrome – Topic Overview
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.
Guillain-Barré Syndrome – Treatment Overview
The main treatment for GBS is preventing and managing complications (such asbreathing problems or infections) and providing supportive care until symptoms begin to improve. This may include:
- Easing your breathing problems, sometimes through the use of a breathing machine (ventilator).
- Monitoring your blood pressure and heart rate.
- Providing adequate nutrition if you have problems chewing and swallowing.
- Managing bladder and bowel problems.
- Using physical therapy to help maintain muscle strength and flexibility.
- Preventing and treating complications such as pneumonia, blood clots in the legs, or urinary tract infections.
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.
- Admission to a hospital or intensive care unit is often needed when muscle weakness progresses quickly. Muscle weakness may rapidly affect the muscles that control breathing. In such cases, temporary use of a mechanical ventilator may be necessary to help you breathe until you can breathe on your own again.
- Careful outpatient monitoring may be enough in cases where significant muscle weakness has not developed. It is important to continue to watch closely for any signs that the condition is getting worse so that you can contact your doctor or hospital immediately.
- You probably will need to be hospitalized if you:
- Are unable to move around on your own.
- Have significant paralysis.
- Have breathing problems.
- Have blood pressure problems or an abnormal, very fast, or very slow heart rate.
If possible, you will be referred to a medical center 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 physical therapy 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.
Physical therapy 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.
- Many people have some minor long-term effects, such as numbness in the toes and fingers. In most cases, these problems will not significantly interfere with your lifestyle.
- About 20% of people have permanent problems that tend to be more disabling, such as weakness or balance problems. These problems may interfere with daily activities.3
- About 3% to 8% of people who develop GBS die from complications of the illness, such as respiratory failure, infection (often pneumonia), or heart attack.3
- Up to 67% of people who get GBS have some problems with persistent fatigue.2
Relapses or repeated episodes of GBS happen in about 5% to 10% of cases, and they may be very serious. 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.