Guillain-Barre Syndrome (GBS)
GBS is short for Guillain-Barre (ge-ON bah-RAY) syndrome. GBS affects the nerves that lie outside the brain and spinal cord. These nerves include the nerves of the legs, arms, abdomen, and chest. They are called peripheral (per-IF-er-ol) nerves. In GBS, the body’s immune system attacks these nerves. When you have GBS, often the first symptoms are weakness and numbness in your legs. The symptoms may then move up your body toward your arms and chest.
GBS can advance in only hours or days, or it may take up to 3 or 4 weeks. Most people have their worst weakness about 3 weeks after GBS starts. It may last for a few weeks or for months. Most people recover from GBS, even from severe cases. They return to normal in a few months. Other people continue to have some weakness.
What causes GBS?
No one knows what causes GBS, but we know something about what happens. In GBS, the body’s immune system does not work right. It starts to attack the body itself. We call this type of disorder an auto-immune disease. In GBS, it seems that the immune system prevents the nerves from sending signals to the muscles. The muscles then receive few or no signals telling them what to do. It also is difficult for muscles to send signals back to the brain. The result is muscle weakness and sometimes numbness and tingling.
Anyone can get GBS — no matter what age or ethnic background. Older people are more prone to get it. Some people get GBS a few days or weeks after they have a virus, such as the flu or diarrhea. In some people, surgery or certain vaccines may trigger it. Because the cause is not known, there is no way to prevent GBS.
What are the symptoms of GBS?
Symptoms of GBS occur suddenly on both sides of the body:
- Weakness, tingling, or loss of feeling in the feet and legs
- Weakness in the arms or upper body
- Numbness, tingling, and pain throughout the body
- Trouble breathing
- Trouble moving the eyes or face muscles
- Trouble talking, chewing, or swallowing
- Problems with bladder control
- Inability to move the legs, arms, breathing muscles, and face
How is GBS detected?
In the early stages, symptoms of GBS are like those of other nervous system disorders. This makes it difficult for doctors to identify GBS as the problem. Tests that may be used to help detect GBS include:
- Spinal tap (lumbar puncture) — This procedure takes a sample of fluid from your spine for lab testing. If you have GBS, the fluid has more protein in it than usual, but you have no signs of infection. First, a drug will numb the area on your spine, and then a needle will be inserted into your spinal canal (usually in the lower back).
- Nerve conduction studies — These tests apply a mild electric current to a nerve. The purpose is to measure the electric activity in a muscle after the nerve is stimulated. These tests look at how well the nerves send messages to the muscles. If you have GBS, the nerves slow or block the relay of messages.
How is GBS treated?
There is no cure for GBS. There are therapies that can make the illness less severe and speed up recovery. For most people, 2 main treatments can help to do this:
- Immunoglobulin (IM-you-no-GLOB-you-lin) infusion — The immune system attacks invading foreign bodies, such as viruses or bacteria, with natural proteins called antibodies. Immunoglobulin (IG) also contains these types of proteins. IG is effective in treating GBS, but the exact reason is not known. High doses of IG seem to block damaging antibodies in your blood that may be attacking the nervous system. You receive IG by injection into a vein.
- Plasmapheresis (plaz-muh-fer-EE-sis) — This treatment removes immune cells from your blood. The immune cells are in the liquid part of the blood, which is called plasma. In this procedure, the plasma is separated from the blood cells. Then the blood cells are put back into your body without the plasma. Your body quickly makes new plasma. It is not known why this treatment works. It may help to remove damaging antibodies from your blood.
The most important part of treatment is to keep your body functioning while your nervous system recovers. Your body may need help from machines. For example, some patients may need a respirator to help them breathe. Sometimes a heart monitor is necessary to watch for heart problems.
Is rehab necessary?
At the worst stage of GBS, you may be unable to move. Your caregivers may have to manually move your arms and legs to exercise them. This helps your muscles to stay flexible and retain some strength. To function on your own again, your muscles will need to regain normal strength and movement. As you begin to recover, you will probably start physical therapy. You may need to go to a rehabilitation center for more therapy to become completely independent again.
While you recover, you also may need to use devices such as a wheelchair or braces. These devices are called “adaptive” devices. They help you to move around and care for yourself until you can do it on your own.
Can GBS come back?
There is a chance that you could get GBS again. But your chance is no greater than if you never had GBS.
For more information
Some helpful resources include:
Guillain-Barre Syndrome Foundation International
P.O. Box 262Wynnewood, PA 19096
National Institute of Neurological Disorders and Stroke
P.O. Box 5801Bethesda, MD 20824
Centers for Disease Control and Prevention