What Is Guillain-Barré Syndrome?
Medically reviewed by Nicholas R. Metrus, MD
Guillain-Barré syndrome (GBS) is an autoimmune disease that usually happens after a viral illness, vaccination, or infection with a specific bacteria called Campylobacter jejuni. Autoimmune diseases occur when the immune system mistakenly attacks healthy cells; research hasn't determined why this happens, but autoimmune diseases often have a genetic cause or follow another illness or infection.
In Guillain-Barré syndrome, the healthy cells that become damaged are part of the peripheral nervous system, the body system that connects your brain and spinal cord to the rest of the body. The peripheral nervous system depends on nerve cells called axons, which are responsible for controlling your muscle movements and your sensory input (like your sense of temperature and pain). When these nerve cells become damaged because of Guillain-Barré syndrome, people experience muscle weakness, tingling, loss of sensation, and sometimes temporary paralysis.
Guillain-Barré syndrome is not common, affecting about less than 6,000 people per year. Though it can be scary, it usually begins to improve within two to three weeks with proper medical treatment (though it may take months or years to fully recover).
Types of GBS
Guillain-Barré Syndrome (GBS) is usually split up into four types, with each type describing the part of the peripheral nervous system that has been affected. Other than the location of the nerve damage, there isn’t much difference between the causes, symptoms, and treatments of the four types.
Acute Inflammatory Demyelinating Polyradiculoneuropathy (AIDP)
Acute inflammatory demyelinating polyradiculoneuropathy, or AIDP, is the most common type of GBS. When the body’s immune system attacks the peripheral nervous system, something called myelin is destroyed; myelin is a layer of protein and fat surrounding the nerves that protects the nerve axons.
Acute Motor Axonal Neuropathy (AMAN)
In this type of GBS, axons—not myelin—are destroyed by the body’s immune response. However, only motor axons, or axons in charge of muscle movement, are affected.
Acute Motor-Sensory Axonal Neuropathy (AMSAN)
This type of GBS is the same as acute motor axonal neuropathy, except both motor axons and sensory axons (which send signals relating to pain, temperature, and touch) are affected.
Miller Fisher Syndrome
Miller Fisher syndrome (MFS) is a rare form of GBS. It affects the nerves in the lower half of the head and in the face, often causing muscle weakness of the eyes, blurry vision, and facial paralysis, along with more typical GBS symptoms.
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Guillain-Barré Syndrome Symptoms
Symptoms of GBS and their intensity can vary depending on the type you have and how severe your case is. However, some symptoms are more common, such as weakness and a tingling sensation.
Weakness
Muscle weakness is one of the earliest and most common symptoms of GBS. Usually, weakness starts in the legs or fingers and then travels upward to the torso and often the face. It can be difficult to walk or control your body, and the weakness can even affect your throat or breathing muscles, making it hard to swallow or take full breaths.
Tingling
Part of the sensory changes you might notice with GBS, a tingling or crawling sensation is common. Some people may experience these changes as numbness, and others may experience muscle pain, especially in the back or legs.
Paralysis
Sometimes, GBS can develop into paralysis, or total loss of the ability to move. This is considered a severe side effect of GBS and doesn't occur in every case. Most people who get to the point of paralysis will still recover with proper medical care.
Other Symptoms
Some other symptoms can occur with GBS because of muscle weakness. Depending on the type of GBS and your individual case, you may also have:
Eye weakness or vision problems
Loss of coordination
Problems with digestion
Loss of bladder control
Abnormal blood pressure or heart rate
Loss of normal reflexes
Causes
Like other autoimmune diseases, researchers aren’t yet sure what causes your body’s immune system to begin attacking itself. It’s possible that your immune system mistakes the chemicals on nerve cells for the chemicals found on viruses and bacteria.
GBS usually begins after an infection; about 70 percent of people with GBS report having been sick between one and six weeks before experiencing GBS symptoms. The infections that can cause GBS include viral infections, like influenza (the flu), Zika, or COVID-19, and infections with Campylobacter bacteria, a common cause of diarrhea in the United States.
Less commonly, GBS is triggered by a routine immunization, with vaccines for seasonal flu and COVID-19 being most commonly connected to cases of GBS. However, your risk of developing GBS is still higher after infection with those illnesses than with vaccination against them.
Other than having had a recent illness, there aren’t any risk factors for GBS—anyone can develop it, though it’s more common in people over the age of 50.
Diagnosis
The main way that GBS is diagnosed is with a physical exam, especially one focused on symptoms related to the nervous system. After taking a medical history and asking you about your symptoms, a healthcare provider will assess your muscle strength and reflexes, and may ask about any recent illnesses or vaccinations.
They will also check if your symptoms are occurring on both sides, since that is common for GBS, and will ask how and when your symptoms started: GBS typically comes on suddenly and gets increasingly worse, which sets it apart from other similar nervous system disorders. It’s also extremely unlikely to get GBS more than once, so having it before could also point your provider towards the right diagnosis.
In addition to the physical exam, a provider may also want to perform the following tests:
Blood work: This can help determine if you had a recent illness that could be causing GBS
Magnetic resonance imaging (MRI): An MRI can be performed on your brain and spine to rule out other causes of your symptoms.
A lumbar puncture: This procedure collects a sample of fluid from your spine to check for signs of disease.
Nerve conduction velocity test (NCV): An NCV measures how well electrical impulses are being conducted along your nerves, assessing your muscle strength
Electromyography (EMG): This is similar to an NCV. It measures muscle activity and can identify causes of muscle weakness.
Treatments for Guillain-Barré Syndrome
There is no outright cure for GBS, but it is a temporary condition and will resolve over time and with proper treatment and care. Some treatments can help speed up recovery time. Because GBS can cause complications, treatment usually requires spending some time in the hospital, with your vital signs (like heart rate, breathing, and blood pressure) being closely monitored, until your symptoms start to improve.
There are several treatments that might be given to people with GBS, but the most common approach is something called immunotherapy, which involves stimulating the immune system so it works better to fight illness.
The two types of immunotherapy used for GBS are:
Plasma exchange, or plasmapheresis, is used to remove harmful antibodies from your blood and replace red blood cells with new, healthy ones.
Intravenous immunoglobulin therapy (IVIg) involves injecting special proteins called immunoglobulins into your blood to help regulate your immune system’s response to nerve cells.
Once you have started to improve, treatments such as physical therapy and speech therapy may be needed to help you fully recover, depending on how severe your muscle weakness was during the acute stage of your illness.
Prevention
Unfortunately, there is no way to prevent GBS: it can affect anyone, and experts don’t know how or why some people’s immune systems attack the peripheral nerve cells.
You can prevent some complications of GBS by receiving immediate medical attention if you notice any of the symptoms of the disease (especially after a recent illness), but the only real prevention strategy for GBS is to avoid the types of illnesses that often trigger it, like flu, COVID-19, and other viral infections. This means practicing good hand hygiene, isolating from sick people, and receiving the appropriate vaccinations against viral illnesses.
Complications
Because various muscles in your body help keep it functioning correctly, the muscle weakness that occurs with GBS can interfere with many other body systems. People with GBS should be treated in a hospital setting so healthcare providers can monitor for complications like high or low blood pressure, blood clots, abnormal heart rate, and other infections.
Even if you don’t experience any of these more severe complications, GBS can cause lifelong side effects like fatigue, pain, weakness, and numbness; this is especially true if you don’t receive any immunotherapy treatments, which work best when given as early as possible after the onset of illness (preferably within the first two to four weeks).
A Quick Review
Guillain-Barré syndrome (GBS) is an autoimmune disease that typically occurs after illness, infection, or vaccination. The immune system mistakenly attacks the nerve cells of the peripheral nervous system, which controls muscle movements and your body’s sense of touch. GBS causes muscle weakness, numbness, and pain; in more severe cases, it can cause temporary paralysis as well as difficulty breathing and swallowing.
Though GBS can be frightening and usually requires hospitalization, it’s most often temporary. Even severe cases typically respond well to treatment with immunotherapy. Most people with GBS begin to improve within the first four weeks, though some symptoms can linger and a full recovery may take months or years.
Frequently Asked Questions
What is the life expectancy for someone with Guillain-Barré syndrome?
Guillain-Barré syndrome usually doesn’t affect a person’s life expectancy, though less than five percent of people with GBS do not survive the illness. Most people recover fully, and the people who have permanent side effects don’t experience a shorter lifespan as a result.
Does Guillain-Barré syndrome come on suddenly?
Yes, it usually comes on suddenly, with increasing muscle weakness over several hours or days.
Can you reverse Guillain-Barré syndrome?
Guillain-Barré syndrome typically resolves itself with proper care and treatment after several weeks or months. Some people continue to have symptoms for years after their illness, but some research suggests even those with long-term symptoms will make a full recovery within five years.
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