What is Guillain-Barré syndrome?

Guillain-Barré syndrome (GBS) is a rare disorder that causes your body’s immune system to attack your nerves. The damage to your nerves causes muscle weakness, tingling, and sometimes paralysis (no movement of the muscles at all). The symptoms may appear over a few hours to weeks.

What is the cause?

The exact cause of Guillain-Barré is not known. Many people with GBS will recall having an infection several weeks before the symptoms started, such as:

• A viral infection, like a cold or flu
• Infection from bacteria found in contaminated water or food (food poisoning)

Rarely, Guillain-Barré has happened after surgery or a tetanus, hepatitis, or flu vaccination. GBS can happen at any age although it is more common in older men.

What are the symptoms?

The symptoms of Guillain-Barré syndrome usually start in your lower legs with tingling, weakness, and numbness. These symptoms can make it hard to walk. During the next few days or weeks, the nerve damage may spread to other parts of your body and symptoms may include:

• Tingling, weakness, and numbness in your arms and upper body
• Severe pain in your shoulders, back, and legs
• Trouble with eye movement, speaking, or swallowing
• Trouble breathing
• Trouble controlling your bowel or bladder

Over time, the weakness may get so bad that you cannot breathe on your own or move at all.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:

• Lumbar puncture, also called a spinal tap, which uses a needle to get a sample of fluid from the area around your spinal cord.
• Nerve conduction studies, which use small wires that are taped to your skin to send mild electric signals and check how well your nerves work to carry signals to your muscles. It may be done before an EMG test.
• An EMG (electromyogram), which uses needles passed through your skin to send mild electric signals and check how your nerves and muscles respond. This test looks for damage to muscles, nerves and the pathways between them.

How is it treated?

There is no treatment that cures Guillain-Barré syndrome. Most people will get better without treatment. However, treatment may make your symptoms better and help you recover more quickly and may include:

• Immunoglobulin therapy: Shots of immunoglobulin can stop your body from making antibodies that attack your immune system.
• Plasma exchange: This is a process to remove blood and separate red and white blood cells from the liquid part of your blood (plasma). Plasma contains the chemicals that are attacking your nerves. The blood cells are given back to you without the plasma. Your body then quickly makes new plasma.
• Physical therapy. Physical therapy helps you use and strengthen your muscles as you recover. These types of therapy can make it easier for you to take care of yourself. You may learn how to use devices such as walkers or wheelchairs to help you get places or stay in certain positions. Braces can also help by supporting joints when your muscles are not very strong.

You will need to stay in the hospital, and you may need a machine to help you breathe, until your symptoms get better. You may need treatments to prevent problems such as pneumonia and blood clots.

For most people the weakness gets worse for 2 or 3 weeks and then starts getting better and, after a time, goes away completely. However you may have weakness for months or years. Guillain-Barré syndrome may come back many years after the first attack.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. In addition:

• Take care of your physical health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet. Limit caffeine. If you smoke, quit. Avoid alcohol and drugs. Exercise according to your healthcare provider’s instructions.
• Get support. Talk with family and friends. Join a support group in your area.

Ask your healthcare provider:

• How and when you will hear your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

You can get more information from:

• Guillain-Barré Syndrome Foundation International
  610-667-0131
  http://www.gbs-cidp.org
• National Institutes of Health Web site for Guillain-Barré Syndrome
  http://www.ninds.nih.gov/disorders/gbs/gbs.htm
• Brain Resources and Information Network (BRAIN)
  800-352-9424