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Guillain-Barre Syndrome

Overview

Guillain–Barre syndrome (GBS) is a rare but serious condition where the body’s own immune system mistakenly attacks the nerves. This leads to muscle weakness, tingling, and sometimes paralysis that usually starts in the legs and spreads upward. It is a prevalent cause of acute neuromuscular paralysis. 

Regional variants of GBS include:

  • Miller Fisher syndrome: affects eye movement, balance, and reflexes
  • Acute motor axonal neuropathy (AMAN): affects motor nerves
  • Acute sensory or sensory-motor forms: affect sensation
  • Pharyngeal-cervical-brachial form: weakness in face, neck, and arms

GBS usually develops quickly, with symptoms peaking within 4 weeks:

  • Gradually worsening ascending muscle weakness, sometimes accompanied by paraesthesia, with symptoms typically peaking within four weeks
  • Progressive loss of tendon reflexes
  • Back pain and radicular discomfort
  • Weakness in respiratory muscles
  • Cranial nerve dysfunction, affecting facial and bulbar muscles
  • Autonomic system involvement
  • Occasional bladder and bowel dysfunction

Guillain–Barre syndrome is an acquired neuropathy caused due to the formation of autoantibodies (proteins that mistakenly attack the body’s own nerves), which are generated in response to infections caused by Campylobacter jejuni, Cytomegalovirus (CMV), Epstein–Barr Virus, Haemophilus influenzae, and Mycoplasma pneumoniae.

To confirm GBS and rule out other conditions, doctors may perform:

  • Blood tests to rule out conditions mimicking GBS like hypokalaemia, porphyria
  • CSF examination for albuminocytological dissociation
  • Antibody measurements to identify specific subtypes
  • Nerve conduction studies (NCV/EMG) show whether nerves are damaged or demyelinated
  • MRI to determine enhancement of nerve roots

Although there is no cure, timely treatment can greatly improve recovery:

  • Intravenous immunoglobulin (IV Ig): the treatment of choice that helps block harmful antibodies.
  • Plasma exchange (PE): filters antibodies out of the blood
  • Disease-modifying therapy
  • General supportive management:
    • Monitoring of swallowing dysfunction
    • Management of respiratory insufficiency
    • Autonomic dysfunction management- arrhythmia/ blood pressure fluctuations
    • Thromboembolic complication prevention
    • Neuropathic pain treatment with gabapentin, carbamazepine, or tramadol
  • Physiotherapy to restore muscle strength and prevent stiffness

Seek urgent medical help if you develop:

  • Rapidly worsening muscle weakness starting in the legs
  • Difficulty breathing, speaking, or swallowing
  • Loss of reflexes or paralysis spreading quickly

There is no definite way to prevent GBS since it is linked to unpredictable immune reactions. However:

  • Prompt treatment of infections may lower risk
  • Safe food and hygiene practices can reduce exposure to harmful bacteria 

For diagnosis and management of GBS, consult a Neurologist (specialist in brain and nerve disorders).

Disclaimer:

The information in this Health Library is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional with any questions about a medical condition or before starting any treatment. Use of this site and its content does not establish a doctor–patient relationship. In case of a medical emergency, call your local emergency number or visit the nearest emergency facility immediately.