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Guillain-Barré Syndrome

(Acute Inflammatory Demyelinating Polyradiculoneuropathy; Acute Inflammatory Demyelinating Polyneuropathy; Acute Idiopathic Polyneuritis; Acute Inflammatory Polyneuropathy; Acute Autoimmune Neuropathy; Idiopathic Polyneuritis; AIDP)

Pronounced: gee-yan bah-ray sin-droam

 

Definition

Guillain-Barré syndrome is a rare condition that causes the immune system to attack the nerves outside of the brain and spinal cord. It is characterized by numbness, tingling, weakness, or paralysis in the legs, arms, breathing muscles, and face. It can affect all ages.

Nervous System

CNS and PNS

Copyright © Nucleus Medical Media, Inc.

 

Causes    TOP

The exact cause of Guillain-Barré syndrome is unknown. However in about three-fourths of people, a recent infection or surgery triggers an autoimmune response. This autoimmune response attacks the peripheral nerves, leading to weakness and a loss of sensation.

 

Risk Factors    TOP

Guillain-Barré syndrome is more common in men, and in the those aged 15-35 years and 60-75 years old. Other factors that increase your chance of Guillain-Barré syndrome may include:

  • Recent gastrointestinal or respiratory infection by viruses or bacteria
  • Recent vaccination—especially influenza and meningococcal
    • The swine flu vaccine given from 1976-1977 was linked to excess cases of Guillain-Barré syndrome. Since then, influenza virus vaccines have been associated with only a slight increased risk of Guillain-Barré syndrome.
  • Recent surgery
  • History of lymphoma, systemic lupus erythematosus, or HIV infection
  • Recent treatment of cancer with immunotherapy
 

Symptoms    TOP

The first symptoms of Guillain-Barré syndrome include:

  • Pain—the lower back pain is the most common complaint
  • Progressive muscle weakness on both sides of the legs, arms, and face
  • Prickly, tingling sensations, usually in the feet or hands
  • Loss of normal reflexes

Symptoms may develop over a period of hours, days, or weeks. They will vary in severity from minimal to total paralysis including respiratory weakness. The symptoms progress and worsen. Most people experience the greatest weakness during the second or third week.

Related complications include:

  • Facial weakness
  • Blood pressure instability
  • Heart rate changes
  • Sweating abnormalities
  • Heart arrhythmias
  • Urinary/gastrointestinal dysfunction
  • Breathing difficulty
  • Death

Most people fully recover, but others may have residual symptoms, or permanent or disabling problems.

 

Diagnosis    TOP

You will be asked ask about your symptoms and medical history. A physical exam will be done.

Tests may include:

 

Treatment    TOP

Treatment aims to reduce the body’s autoimmune response and decrease complications that result from immobility. Hospitalization is important because symptoms may rapidly become more severe, including respiratory failure, heart arrhythmias, and blood pressure instability.

Common treatments include:

Plasmapheresis

During plasmapheresis, blood is removed from your body and passed through a machine that separates blood cells. The separated cells are then returned to your body with new plasma. This procedure may help shorten the course and severity of Guillain-Barré syndrome.

High-dose Immunoglobulin Therapy

IV infusion with immunoglobulin (IVIg) may help reduce the severity of a Guillain-Barré attack. Immunoglobulins are proteins that are naturally produced by the body’s immune system.

Mechanical Ventilation    TOP

In some cases, muscles necessary for breathing become paralyzed. This is treated with immediate emergency support from a mechanical ventilator.

Medications    TOP

Your doctor may advise

  • Over-the-counter or prescription pain relievers
  • Antiseizure medications
 

Prevention    TOP

There are no current guidelines to prevent Guillain-Barré syndrome.

RESOURCES:

Guillain-Barré Syndrome Foundation International
http://www.gbs-cidp.org

National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov

CANADIAN RESOURCES:

Canadian Institute for Health Information
http://www.cihi.ca

Health Canada
https://www.canada.ca

REFERENCES:

Guillain-Barre syndrome. EBSCO DynaMed Plus website. Available at: Available at: http://www.dynamed.com/topics/dmp~AN~T116758/Guillain-Barre-syndrome . Updated April 28, 2017. Accessed February 14, 2018.

Vucic S, Kiernan MC, Cornblath DR. Guillain-Barre: an update. J Clinical Neuroscience. 2009;16(6):733-741.



Last reviewed March 2018 by EBSCO Medical Review Board Rimas Lukas, MD
Last Updated: 5/7/2014

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