Guillain-Barré Syndrome (GBS)

GBS can develop in any person, at any age, regardless of gender or ethnicity. It is characterized by a rapid onset of weakness and often paralysis of the legs, arms, respiratory muscles, and facial muscles.

What is Guillain-Barré Syndrome (GBS)?

Guillain-Barré syndrome, also known as acute idiopathic polyneuritis and Landry’s ascending paralysis, is an inflammatory disorder of the peripheral nerves (nerves outside the brain and spinal cord). It is characterized by a rapid onset of weakness and often paralysis of the legs, arms, respiratory muscles, and facial muscles. Weakness is frequently accompanied by abnormal sensations such as tingling and pain.

Many patients in the early phase of the disease require treatment in an intensive care unit, especially if mechanical ventilation is needed or if swallowing is affected. Although most people recover, recovery may take months, and some patients may be left with long-term disabilities of varying severity.

The mortality rate is less than 5%. GBS can affect any individual at any age, regardless of gender.

What causes GBS?

The exact cause is unknown. In about 50% of cases, the disease occurs shortly after a microbial infection (viral or bacterial), including common and mild infections such as influenza or food poisoning.

Some theories suggest an autoimmune trigger, in which the body’s defense system—antibodies and white blood cells—mistakenly attacks its own tissues. This immune response damages myelin (the protective sheath or insulation of nerves), leading to numbness and weakness.

How is GBS diagnosed?

In most cases, patient symptoms and physical examination are sufficient to suggest the diagnosis. Rapidly progressive weakness, often accompanied by abnormal sensations and affecting both sides of the body symmetrically, is a typical presentation.

Loss of deep tendon reflexes, such as the knee (patellar) reflex, is commonly observed. To confirm the diagnosis, a lumbar puncture may be performed to detect elevated protein levels in cerebrospinal fluid, as well as nerve conduction studies and electromyography (EMG).

How is GBS treated?

GBS is unpredictable in its early stages, and therefore most newly diagnosed patients are hospitalized, except in very mild cases. Patients are often admitted to intensive care units for close monitoring of breathing and other vital functions until the condition stabilizes.

Plasma exchange (a “blood cleansing” procedure) and high-dose intravenous immunoglobulin (IVIG) are often effective in shortening the course of the disease.

The acute phase of GBS usually lasts from a few days to several months, with more than 90% of patients entering the recovery phase within four weeks.

Patient care requires a coordinated multidisciplinary team that may include a neurologist, physiatrist (rehabilitation physician), internist, general practitioner, physiotherapist, occupational therapist, social worker, nurse, and a psychologist or psychiatrist. Some patients may also require speech therapy if speech muscles are affected.