Guillain-Barre syndrome

Sounds like 'gee-YAN bah-RAY'

Guillain-Barre syndrome is an autoimmune disorder that affects the nervous system. Autoimmune means that the body attacks itself, without any real known cause or reason.

Key facts about Guillain-Barre syndrome

  1. Guillain-Barre syndrome is a rare condition, affecting 40 to 100 New Zealanders each year
  2. It can occur at any age, but is a bit more common in the elderly and is also more common in men than women
  3. Guillain-Barre syndrome causes muscle weakness, loss of reflexes and numbness or tingling (pins and needles) in the arms, legs, face and other parts of the body. In severe cases it can cause complete paralysis
  4. Worsening of the disease always stops within 4 weeks and there is a long recovery phase thereafter
  5. The exact cause of Guillain-Barre syndrome is unknown, but it seems to occur after a viral or bacterial infection

What is Guillain-Barre syndrome?

Guillain-Barre syndrome is a disorder in which your body's immune system attacks the covering of certain nerves (called myelin sheath). This causes damage to the nerves. There are 3 types of Guillain-Barre syndrome:

  • Acute inflammatory demyelinating polyradiculoneuropathy (AIDP)
    • This is the most common form, and usually starts with muscle weakness in the lower part of your body and spreads upward.
  • Miller Fisher syndrome (MFS)
    • In this form the paralysis starts in the eyes leading to double vision, droopy eyelids and uncoordinated or imbalance in movement.
  • Acute motor axonal neuropathy (AMAN) and acute motor-sensory axonal neuropathy (AMSAN) 

What causes Guillain-Barre syndrome?

Medical experts do not know the exact causes of Guillain-Barre syndrome, but think that it may be started or prompted by:

  • food poisoning (Campylobacter)
  • flu
  • viral infections
  • childbirth
  • surgery
  • vaccinations.

Guillain-Barre syndrome is not hereditary (you do not get it from your parents genetics) and is not infectious or contagious (it cannot be passed on from person-to-person). 

What are the symptoms of Guillain-Barre syndrome?

The most common symptoms of Guillain-Barre syndrome are:

  • numbness or tingling in your hands and feet and sometimes around the mouth and lips
  • weakness of the muscle in your legs, arms and the sides of your face
  • difficulty with speaking, chewing, and swallowing
  • problems with moving your eyes
  • back pain. 

Symptoms usually start with numbness or tingling in the fingers and toes, and over a few days, muscle weakness in the legs and arms develops.

  • This usually affects both sides of the body. 
  • The legs may feel heavy, wooden and weak and the arms may feel limp.
  • Gripping, turning or holding things may be difficult.
  • Rising from a chair may become a problem.
  • Most patients feel very weak, and are unable to get out of bed. Some patients may suffer a lot of pain.

In the early stages the symptoms can be confusing and puzzling and it may be hard to convince others that there really is something wrong.

How is Guillain-Barre syndrome diagnosed?

Your doctor will ask when your symptoms started and how they have changed, and may also ask if you've had any recent infections. Your doctor also may do tests, such as a lumbar puncture and a nerve conduction study. 

What are the treatment options?

The is no cure for Guillain-Barre syndrome. It usually gets better on its own over time, as the nerves repair themselves.

  • Guillain-Barre syndrome is usually treated in hospital, where your breathing, heart rate, and blood pressure can be carefully tracked.
  • In severe cases, you may be treated with:
    • Plasma exchange where blood is taken out of your body, the harmful antibodies are removed from the blood, and then the blood is returned to your body.
    • Intravenous immune globulins – which are helpful antibodies that are added to your blood.

These treatments are used for more severe cases and have been found to shorten the length of the illness. 

Recovery

Most people with Guillain-Barre syndrome will make a full recovery in 6 to 12 months. However, you may be in hospital for a few months.  A few people (about 1 to 2 in 10 people) will be left with some degree of permanent problems such as some weakness, muscle wasting, difficulty walking or pain.

Learn more

The following links provide further information on Guillain-Barre syndrome. Be aware that websites from other countries may contain information that differs from New Zealand recommendations.

Guillain Barré Syndrome Guillain Barré Syndrome Support Group NZ Trust 
Guillain-Barré Syndrome Patient Info, UK

Credits: Health Navigator Team. Last reviewed: 10 Mar 2016