GBS affects the peripheral nerves, which connect to your muscles and control sensations like pain and temperature. It can cause muscle weakness that spreads from your legs to your arms and face. It can make it difficult to walk or climb stairs and can interfere with your breathing.
Symptoms usually start within six weeks of an infection. Most often, people report a respiratory or gastrointestinal infection such as Campylobacter jejuni or CMV, Epstein-Barr virus, Mycoplasma pneumoniae, or influenza A virus.
Symptoms
Guillain Barre syndrome is a rare condition that causes your body’s immune system to attack your nerves, causing weakness and possibly paralysis. It typically starts in the feet and legs, but it can spread to other parts of your body. Most people recover completely from GBS, but it can be life-threatening if the weakness affects your muscles that control breathing.
GBS, also called acute inflammatory demyelinating polyradiculoneuropathy (AIDP), is caused by an infection with the bacteria Campylobacter jejuni, often found in undercooked poultry. It’s not known exactly what triggers GBS, but it often occurs days or weeks after a stomach or respiratory illness. It can also follow surgery or a vaccination.
Symptoms of GBS are muscle weakness or tingling, usually starting in the feet and legs and spreading to other parts of your body over hours or weeks. This muscle weakness can lead to trouble walking and difficulty climbing stairs. In more severe cases, the weakness can move to your arms and chest and prevent you from breathing. GBS can be hard to diagnose in its early stages because your symptoms may be similar to those of other conditions. Your doctor will start by asking you about your past health and doing a physical exam. They may also do a spinal tap, or lumbar puncture. This involves taking a small amount of fluid from your lower back and testing it for a change that commonly happens in people with GBS. They’ll also do an electromyography test, which uses thin needles inserted into your muscles to measure how well your nerves and muscles respond to small electrical pulses.
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Usually, treatment for GBS begins with medication to reduce your immune response and support your nerves while your nervous system recovers. It can take months to several years for you to fully recover from the condition. You’ll likely need rehabilitation, including physiotherapy and occupational therapy. You may need speech and language therapy to help you communicate with others, as well as swallowing therapy if you have any difficulty eating or drinking. Maintaining a strong support network can be helpful in this time.
Diagnosis
GBS is a serious illness that can progress to muscle weakness and sometimes paralysis. It affects people of all ages, but is more common in adults and males. It is thought that it may be triggered by infection. Most cases of Guillain Barre Syndrome occur after a respiratory or gastrointestinal infection.
The symptoms of GBS are similar to a cold or flu. They begin with tingling or numbness, often in the feet and hands. Symptoms then spread up the legs and arms. Occasionally they begin in the face or chest. Generally the weakness affects both sides of the body equally. The weakness, numbness and pain usually improve over time. However, it can take up to six months for the strength to return.
Doctors diagnose GBS by asking about your symptoms and how long they have been happening. They will also want to know what infections you have had recently. They will also ask you if you have had any recent vaccinations. It is thought that GBS is a result of your immune system mistaking the nerves for germs and attacking them. The damage causes the sheaths around the nerve fibers to break down, which stops the transmission of nerve impulses. In severe cases this can lead to trouble breathing and a life-threatening condition called Guillain Barre Syndrome.
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If your symptoms get worse, you should see your GP immediately as this is a medical emergency. If they are very severe, you may need to be rushed to hospital to have a machine help you breathe. Most people with GBS recover completely and do not have any lasting problems, but it can be very difficult to cope with the fatigue and muscle weakness.
In some cases, GBS can cause complications that include blood clots and problems with bowel and bladder function. Those who are not mobile because of the illness may need to take blood thinners to prevent clots from forming. Some people have to wear stockings to improve their blood flow. If your symptoms are very severe, you may need to stay in hospital for several weeks or months.
Treatment
Guillain Barre syndrome affects your peripheral nerves, which control muscle movement and sensory functions like pain signals and temperature and touch sensations. It can lead to muscle weakness, tingling sensations (paresthesia), and in severe cases can cause paralysis of the legs, arms, face or breathing. Symptoms appear suddenly, usually within days or weeks of infection. They get worse quickly and can be life threatening.
GBS can occur after a viral illness or it can develop without an obvious cause. Most people recover from GBS, but there is a small chance they may die. During recovery, it is important to stay in the hospital so your healthcare team can monitor your condition. They may give you breathing support if needed, and medicines to help prevent complications like low blood pressure or high blood pressure. They may also do a spinal tap, a procedure in which they insert a needle into your lower back to remove cerebrospinal fluid (CSF), which contains information about the status of your nervous system, including how well your brain and spine are functioning.
Several treatment options can speed your recovery from GBS. Plasma exchange (plasmapheresis) is a common treatment that can help improve symptoms by removing the antibodies from your body. In this treatment, a machine separates your plasma from your blood and filters out the antibodies that are attacking your nerves. Another treatment option is intravenous immunoglobulin, which can also help improve symptoms.
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Other treatment options include resting and taking it easy to let your muscles heal. Yale Medicine physicians are trained to identify the most appropriate treatment for each person’s situation. They can evaluate muscle strength, recommend mobility aids and help you find ways to modify your daily activities, conserve energy and reduce fatigue.
Many people who have GBS make a full recovery, but it can take weeks or months. You might still have some weakness, but you should be able to return to your normal daily activities. You might need to use a cane or wheelchair for a while, and you should be careful about getting infections that could worsen your condition.
