Guillain-Barré Syndrome (GBS) Overview

Guillain-Barré syndrome (GBS) is an autoimmune disorder in which peripheral nerves are damaged and cannot transmit signals efficiently. The disease typically progresses from the legs up the body to the trunk and may even affect the respiratory system, causing almost complete paralysis.

In GBS, the myelin sheath protecting the nerves are damaged, so signals traveling along the nerves are not transmitted properly. Because nerves cannot transmit signals to muscles, muscles will not function properly, thus causing paralysis.

Causes

No one knows exactly what causes GBS or why some people get it and others do not. Most people who get GBS do so after having a bacterial infection (e.g. E. coli, pneumonia) or viral infection (e.g. flu, Epstein Barr). In some cases, it has been connected to certain immunizations, such as the flu vaccine; however, the chances of developing GBS is more likely subsequent to contracting the flu than from receiving the flu vaccine.

Symptoms

Because Guillain-Barré is a syndrome and not a disease, it can be very difficult to diagnose. The symptoms are not always the same in every person, but typically reflexes will be lost (e.g. knee jerk reflex) and the paralysis or loss of feeling will occur on both sides of the body rather than just one side or the other. The symptoms of Guillain-Barre also progress quickly, in hours, days or weeks, rather than months like some similar disorders.

Diagnosis

If a doctor suspects GBS, he or she will typically perform a spinal tap to make the diagnosis. Most people have reached the peak of the disorder, meaning the greatest amount of paralysis, in about two or three weeks. Recovery can then take anywhere from a few weeks to months or even years. Electromyography (EMG), nerve conduction studies (NCS), and/or neuroimaging are also used to rule out other lesions.

Treatment

There is no cure for GBS, although it reverses on its own most of the time. It is fatal in a very small percentage of people who develop it.

Both immunoglobulin therapy and plasma exchange are used as treatments. Because of the potential severity of the symptoms and the complexity of the therapies, patients with are usually kept in the hospital in intensive care units. Depending on the symptoms, patients may need to be put on ventilators to assist with breathing and physical therapy may be used so muscle function does not deteriorate.