Overview, Causes, & Risk Factors
Guillain-Barré syndrome, or GBS, is believed to be an autoimmune disorder in which the
body creates antibodies against its own tissue. In people with GBS, the
antibodies generally attack the myelin sheath, or lining of the nerves. They
may also attack part of the nerves themselves.
What is going on in the body?
Guillain-Barré syndrome is thought to be an autoimmune disorder that is
triggered by an infection, vaccination, or other factors. It causes a severe
inflammatory reaction around the nerves. The myelin sheath becomes swollen.
Impulses and messages cannot travel along the course of the nerve. In time,
nerve impulses are blocked.
What are the causes and risks of the condition?
Most cases of Guillain-Barré syndrome are triggered by an
infection. Two-thirds of the individuals with GBS have had an upper respiratory infection or
gastrointestinal infection 1 to 3 weeks before weakness develops. Other
infections that may trigger GBS include:
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HIV infections, which
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Some vaccinations may also trigger Guillain-Barré syndrome. These
immunization against group A
swine flu immunizations
Certain medicines have been identified as triggers for GBS. These
captopril, used to treat high blood pressure
danazol, a hormone derivative
gold, which is injected for diseases such as rheumatoid arthritis
heroin, a highly addictive illegal drug
penicillamine, which is used for chelation and to treat rheumatoid
streptokinase, used to dissolve blood clots
GBS may be triggered by a variety of other factors, such as:
blood cancers, especially Hodgkin
No one knows for sure why these factors trigger Guillain-Barré
syndrome in some people but not in others. More research is needed in this
Symptoms & Signs
What are the signs and symptoms of the condition?
People with GBS usually have muscle weakness or paralysis that
starts in the legs and feet. It progresses up toward the arms and head.
Sometimes the weakness starts in the arms and moves downward. Occasionally, it
starts in the arms and legs at the same time. The spread from feet to head can
occur within 24 to 72 hours but can take longer.
Muscle weakness can lead to the following symptoms:
difficulty urinating or even starting to urinate
loss of bowel and/or bladder control
muscle pain and contractions
numbness and decreased sensation
painful or tingling sensations in the arms and legs
palpitations, or an
unusual awareness of the heart beating in the chest
Diagnosis & Tests
How is the condition diagnosed?
Diagnosis of Guillain-Barré syndrome begins with a medical history
and physical exam. A test called a nerve conduction velocity
(NCV) test can detect damage to the myelin sheath.
electromyograph (EMG) is a test that may be done to show if there
is a lack of nerve signals to the muscles. During an EMG, wires are connected
to the skin, and the activity of nerves and muscles is measured. An
electrocardiogram, or EKG, may also be ordered.
Prevention & Expectations
What can be done to prevent the condition?
Most cases of Guillain-Barré syndrome cannot be prevented.
Following safer sex
guidelines may prevent some cases that are triggered by sexually transmitted diseases, such
as HIV. Illegal drugs, such as heroin, should not be used.
What are the long-term effects of the condition?
About 95% of those with Guillain-Barré syndrome survive. About 75% completely
recover. For some, mild weakness or chronic pain will continue throughout life.
GBS can be fatal if it causes problems with breathing. Full recovery can be
expected if symptoms go away not long after they appear. This usually happens
within 3 weeks.
Weakness and decreased sensation can cause contractures.
Contractures occur because muscles become thick and tight when they are not
used. They shrink and shorten, causing joint deformities. There can also be
loss of movement in the affected areas.
Blood clots may develop because of loss of motion and muscle contractions.
Blood-thinning medicines, such as warfarin or heparin, can be given to help
prevent blood clots. There is an increased risk of infection, including
What are the risks to others?
Guillain-Barré syndrome is not contagious and poses no risk to
others. If GBS is triggered by an infection, the infection itself may be
Treatment & Monitoring
What are the treatments for the condition?
Initial treatment of GBS focuses on life support. A ventilator, or artificial breathing
machine, may be needed. Fluids can be given through an intravenous line. Food can be given through a
tube into the stomach.
A procedure called plasmapheresis can be effective if used early in
the course of the illness. Plasmapheresis removes antibodies that may be
present in the bloodstream. It also provides the person with fluids or plasma
that is free of the antibodies that trigger GBS.
Immunoglobulin therapy is also used to treat GBS. High
doses of immunoglobulins, or proteins from the immune system of normal donors,
are given to the person with GBS. For some unknown reason, these globulins
reduce the body's attack on its own nerves.
Corticosteroids, such as methylprednisolone, are sometimes given together with
plasmapheresis or immune serum globulin. However, their effectiveness is
questionable, and they may worsen the disease.
What are the side effects of the treatments?
Plasmapheresis is associated with a small risk of getting
bloodborne infectious diseases. Corticosteroids and immune globulins may
increase the person's risk for many types of infection.
What happens after treatment for the condition?
therapy may be ordered to prevent contractures and other
complications. Along with
occupational therapy, it can be helpful in restoring the person's
normal level of function. Pain
medicines and physical therapy may be needed if the person has
How is the condition monitored?
After the acute phase of GBS, the individual will have regular
visits with the healthcare provider. Any new or worsening symptoms should be
reported to the provider.