Guillain-Barre Syndrome: NWHIC

GUILLAIN-BARRE SYNDROME

What is Guillain-Barre syndrome?
What causes Guillain-Barre syndrome?
How is it Diagnosed?
Can it be Treated?
What is the long-term outlook for those with Guillain-Barre syndrome?

See also . . .

• Autoimmune Diseases

What is Guillain-Barre syndrome?

Guillain-Barre (ghee-yan bah-ray) syndrome is a disorder in which the body's immune system attacks part of the nervous system. The first symptoms of this disorder include varying degrees of weakness or tingling sensations in the legs. In many instances the weakness and abnormal sensations spread to the arms and upper body. These symptoms can increase in intensity until the muscles cannot be used at all, and the patient is almost totally paralyzed. This may include a temporary distortion of facial appearance as facial muscles become paralyzed. In these cases the disorder is life threatening -- potentially interfering with blood pressure, heart rate, and breathing -- and is considered a medical emergency. The patient is often put on a respirator to assist with breathing and is watched closely for problems such as an abnormal heartbeat, infections, blood clots, and high or low blood pressure. Most patients, however, recover from even the most severe cases of Guillain-Barre syndrome, although some continue to have minor problems.

Guillain-Barre syndrome can affect anybody. It can strike at any age and both sexes are equally prone to the disorder. The syndrome is rare, however, afflicting only about one person in 100,000. Usually Guillain-Barre occurs a few days or weeks after the patient has had symptoms of a respiratory or gastrointestinal viral infection. Occasionally pregnancy, surgery, or vaccinations will trigger the syndrome. The disorder can develop over the course of hours or days, or it may take up to 3 to 4 weeks. Most people reach the stage of greatest weakness within the first 2 weeks after symptoms appear.

What causes Guillain-Barre syndrome?

No one yet knows why Guillain-Barre strikes some people and not others. Nor does anyone know exactly what triggers the disease. What scientists do know is that the body’s immune system goes awry and instead of attacking only foreign material and invading organisms, it begins to destroy the myelin sheath that surrounds the axons of many peripheral nerves. The myelin sheath speeds up the transmission of nerve signals. As this protective sheath disappears, signals slow and senses (heat, pain) decrease.

How is it Diagnosed?

Guillain-Barre is called a syndrome rather than a disease because it is not clear that a specific disease-causing agent is involved. Reflexes such as knee jerks are usually lost. Because the signals traveling along the nerve are slower, a nerve conduction velocity (NCV) test can give a doctor clues to aid the diagnosis. The cerebrospinal fluid that bathes the spinal cord and brain contains more protein than usual, so a physician may decide to perform a spinal tap.

Can it be Treated?

There is no known cure for Guillain-Barre syndrome, but it will usually go away with time. There are therapies that can lessen the severity of the symptoms and accelerate the recovery in most patients. There are also a number of ways to treat the complications of the disease. Currently, plasmapheresis and high-dose immunoglobulin therapy are used. Plasmapheresis is a procedure in which abnormal antibodies are removed from the blood, which seems to reduce the severity and duration of the Guillain-Barré episode. Intravenous high-dose immunoglobulin therapy temporarily modifies the immune system and provides the body with normal antibodies from donated blood. The most critical part of treatment for this syndrome consists of keeping the patient's body functioning during recovery of the nervous system. This can sometimes require placing the patient on a respirator, a heart monitor, or other machines that assist body function.

What is the long-term outlook for those with Guillain-Barre syndrome?

Guillain-Barre syndrome can be a devastating disorder because of its sudden and unexpected onset. In addition, recovery is not necessarily quick. As noted above, patients usually reach the point of greatest weakness or paralysis within the first two weeks. Symptoms then stabilize at this level for a period of days, weeks, or, sometimes, months. The recovery period may be as little as a few weeks or as long as a few years. About 30% of those with Guillain-Barre still have a residual weakness after 3 years. About 3% may suffer a relapse of muscle weakness and tingling sensations many years after the initial attack.

Guillain-Barre syndrome patients face not only physical difficulties, but emotionally difficult events as well. It is often extremely difficult for patients to adjust to sudden paralysis and dependence on others for help with routine daily activities. Patients sometimes need psychological counseling to help them adapt.

For More Information . . .

You can find out more about Guillain-Barre Syndrome by contacting the following organizations:

National Institute of Neurological Disorders and Stroke, NIH, HHS
Phone: (301) 496-5751
Internet Address: http://www.ninds.nih.gov/

National Organization for Rare Disorders
Phone: (800) 999-6673
Internet Address: http://www.NORD-RDB.com/

Guillain-Barre Syndrome Foundation International
Phone: (610) 667-0131
Internet Address: http://www.webmast.com/gbs/

This information was abstracted from fact sheets developed by the Office on Women's Health in the Department of Health and Human Services and the National Institute of Neurological Disorders and Stroke.

All material contained in the FAQs is free of copyright restrictions, and may be copied, reproduced, or duplicated without permission of the Office on Women's Health in the Department of Health and Human Services; citation of the source is appreciated.

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Publication date: October 23, 2000