Guillain–Barré Syndrome

A disorder in which damage to the peripheral nerves results in weakness that spreads upwards from the legs

  • Age, gender, genetics, and lifestyle are not significant factors

Guillain–Barré syndrome is a rare and potentially life-threatening disorder that causes progressive loss of feeling and weakness that can rapidly lead to paralysis. The condition is the result of an abnormal immune response that develops 2–3 weeks after certain infections, such as infection with Campylobacter jejuni bacteria (see Food poisoning). Rarely, Guillain–Barré syndrome may develop as a complication following an immunization.

In Guillain–Barré syndrome, antibodies that are produced in response to an infection or vaccine attack the peripheral nerves, causing the nerves to become inflamed. Initially, the legs are affected, followed by the trunk, arms, and head. The condition is often mild, but, if severe, Guillain–Barré may cause difficulty in swallowing and breathing. In such circumstances, the affected person may need to have artificial feeding and mechanical ventilation. Each year in the UK about 1–2 people per 100,00 are affected by the syndrome.

What are the symptoms?

The symptoms may develop in a few days or weeks and include:

  • Weakness in the legs, which may spread up the trunk and to the arms.

  • Numbness and tingling of the limbs.

Usually, no further symptoms develop, but, in severe cases, symptoms become progressively worse and include:

  • Paralysis of the limbs.

  • Difficulty in speaking and swallowing.

If the muscles of the ribcage and diaphragm are affected, serious breathing difficulties may develop.

How is it diagnosed?

Your doctor will probably diagnose Guillain–Barré syndrome from your symptoms. However, you may have tests to confirm the diagnosis, including nerve conduction studies (see Nerve and muscle electrical tests). You may also have a lumbar puncture, in which a sample of fluid from around the spinal cord is removed under local anaesthesia for analysis.

What is the treatment?

During the early stages of Guillain–Barré syndrome you will be admitted to hospital, where you will probably be given intravenous infusions of immunoglobulin. An alternative treatment is plasmapheresis, in which plasma (the fluid part of the blood) is withdrawn, treated to remove abnormal antibodies, and replaced. If you have difficulty swallowing, you may be given fluids intravenously or through a tube. If you develop breathing difficulties, mechanical ventilation may be necessary (see Intensive therapy unit). While you are recovering, you may have physiotherapy to help to maintain muscle tone.

What is the prognosis?

About 75 per cent of people with Guillain–Barré syndrome make a full recovery. Mild symptoms usually disappear in a few weeks, but severe symptoms may persist for months. About 20 per cent of people are left with some disability, such as residual numbness or weakness. In about 5 per cent of cases, the syndrome is fatal.

From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.

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