How Guillain-Barré Is Treated

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Guillain-Barré Syndrome (GBS) refers to a family of disorders often triggered by an infection, which causes damage to the peripheral nervous system. There is no known cure for the disease, but there are treatments that may reduce the severity of symptoms as your body recovers. You may also require in-hospital care to manage severe complications of GBS such as respiratory problems.

Two treatment options focus on slowing the ongoing damage to nerve cells and helping quicken recovery.

This article explains how to manage symptoms, treatments to stop nerve damage, and what to expect in terms of a full recovery.

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Lifestyle Changes

To manage the complications of GBS you may need to make some lifestyle changes or use supportive care tools.

  • Pneumonia prevention: GBS can put you at risk for pneumonia and respiratory illness. Discuss with your healthcare provider how you can take extra steps to limit your risk of developing these illnesses.
  • Heart rate monitor: Wearing a heart monitor can help you track your heart function and get emergency assistance if you experience GBS-related cardiac problems.
  • Blood clot prevention: Compression socks, inflatable cuffs, and blood thinners can help prevent blood clots, which are very common as your mobility decreases with GBS.

Hospital Monitoring

Because GBS symptoms can progress quickly and lead to serious complications, it's often necessary to undergo continual monitoring. You may be admitted to a hospital so your healthcare provider can track vital functions.

Breathing: Healthcare providers will track your ability to breathe, taking breathing measurements frequently. Those measures usually include the forced vital capacity the amount of air you can forcibly exhale after taking the deepest breath possible.

Swallowing: Loss of involuntary nerve function may decrease your ability to swallow, which may lead you to need a feeding tube.

If your condition continues to weaken, you may be admitted to an intensive care unit and placed on ​mechanical ventilation if necessary. Additional measures may also be needed to regulate other autonomic features such as heart rate and rhythm.

Most people with Guillain-Barré syndrome reach their weakest point within two or three weeks after they first notice their symptoms.

Prescriptions

The main treatment of GBS is focused on lessening the severity of attacks. Researchers have found that the most effective way to do this is by filtering out of the blood problematic antibodies that attack the peripheral nerves. Two types of treatments are commonly used to block these antibodies.

  • Plasmapheresis
  • Immunoglobulins treatment

Both treatments effectively reduce harm to the nervous system and speed up recovery. However, they should be started within two weeks of GBS symptoms appearing.

Plasmapheresis

Plasma exchange (PE) also called plasmapheresis, is similar to kidney dialysis. It involves removing the liquid part of blood (rather than blood cells) from the body. The plasma is then filtered out, and the blood is returned to the body with a substituted fluid in place of the original plasma.

This process is usually done between three to five times, usually with a day in between sessions in order for the body to readjust to the new plasma. Risks are few but include blood problems.

Intravenous Immunoglobulins

Intravenous immunoglobulins (IVIg) is a process by which immunoglobulins from donors without GBS are injected into your body to counter or dilute the malfunctioning antibodies.

IVIg has been shown to shorten the time it takes to recover from Guillain-Barré, although no one knows exactly why it works. The amount of risk is similar to plasmapheresis, but rather than blood problems, IVIg may lead to allergic reactions, hepatitis, or kidney problems.

Research shows that IVIg and plasmapheresis are equally good at treating Guillain-Barré syndrome, and there's no clear benefit to doing both together. In severe cases, some doctors will still sometimes do plasma exchange followed by IVIg.


Prognosis

PE and IVIg are not quick-acting therapies. It takes more than four weeks to see improvement in 40% of people treated with one of the procedures. This doesn't mean that the therapies are not working. In these cases, the disease would progress further if treatments are not administered.

Most people recover well from Guillain-Barré Syndrome, but the speed and completeness of recovery vary significantly. Some forms, such as acute motor and sensory axonal neuropathy (AMSAN), require a longer time to recover.

The more severe the case is the longer the recovery time. Nerves take a long time to grow back—just millimeters a day—and if the damage is extensive, it can take up to a year or more to regain function. In some cases, some deficits, such as difficulty with small finger movements or residual numbness, will remain.

Rehabilitation

As GBS symptoms improve, some amount of rehabilitation in the form of various therapies is frequently required for a full recovery.

Summary

The severity of symptoms of GBS varies widely from case to case. Managing numbness, pain, and weakness is the initial step in treating the disease. Because minor symptoms of Guillain-Barré Syndrome can quickly progress and become devastating, your healthcare provider may want to keep you under observation in the hospital.

Two treatments, plasma exchange and intravenous immunoglobulins, are effective at reducing the amount of damage GBS inflicts on the nervous system and quickens recovery time. These treatments need to be started within the first few weeks of symptoms developing.

Treatments may need to be followed up with physical, occupational, or speech therapy to help you make a full recovery.

A Word From Verywell

Guillain-Barré can be a serious disorder, but over 95% of the time, people recover to some degree. Relapse is uncommon, with only about 2% to 6% sliding back. The path can be long and challenging, but in the end, most people are able to leave Guillain-Barré behind them.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. GSB/CIDP Foundation International. Guillain-Barre syndrome.

  2. NIH National Institute of Neurological Disorders and Stroke. Guillain-Barré syndrome fact sheet.

  3. Leonhard SE, Mandarakas MR, Gondim FAA, et al. Diagnosis and management of Guillain–Barré syndrome in ten stepsNature Reviews Neurology. 2019;15(11):671-683. doi:10.1038/s41582-019-0250-9

  4. Guo Y, Tian X, Wang X, Xiao Z. Adverse effects of immunoglobulin therapy. Front Immunol. 2018;9:1299. doi:10.3389/fimmu.2018.01299

  5. Jankovic J. Disorders of Peripheral NervesBradley and Daroff's Neurology in Clinical Practice. 2022.

  6. Kazandjian M, Dikeman K. Guillain-Barre syndrome and disordered swallowingPerspectives on Swallowing and Swallowing Disorders (Dysphagia). 2012;21(4):115. doi:10.1044/sasd21.4.115

Additional Reading
  • Ropper AH, Samuels MA. Adams and Victor's Principles of Neurology, 9th ed: The McGraw-Hill Companies, Inc. McCabe MP, O'Connor EJ.

  • Yuen T. So, Continuum: Peripheral Neuropathies, Immune-Mediated Neuropathies, Volume 18, Number 1.

By Peter Pressman, MD
Peter Pressman, MD, is a board-certified neurologist developing new ways to diagnose and care for people with neurocognitive disorders.