Guillain-Barré Syndrome

Guillain-Barré Syndrome (GBS) is an autoimmune disorder in which the body's immune system attacks part of the peripheral nervous system. Specifically, the immune system begins to destroy the myelin sheath surrounding the axons of peripheral nerves, or the axons themselves, which carry nerve signals. When myelin sheaths are injured or degraded, nerves lose the ability to transmit signals efficiently.

Guillain-Barré Syndrome is rare, affecting only about one person in 100,000, according to the National Institute of Neurological Disorders and Stroke, and no one knows the exact cause. GBS can affect persons of all ages, and both sexes are equally prone. GBS usually occurs a few days or weeks after a patient has had symptoms of a respiratory or gastrointestinal viral infection. GBS can also be triggered by surgery and has been associated with infection with the Zika virus and, in rare cases, with vaccinations.

The initial symptom is typically numbness or tingling sensations in the feet, which spreads to the arms and upper body. Unlike other disorders, symptoms typically appear on both sides of the body and occur very quickly, in hours or days. These symptoms can increase in intensity, resulting in muscle weakness and in the most severe cases, total paralysis. In these cases, GBS can be life-threatening, interfering with breathing, blood pressure or heart rate. When this occurs, a patient is often put on a ventilator to aid in breathing. Fortunately, most patients recover from even the most severe cases, although there can be residual weakness.

Given the sudden, unexpected onset and the severity of symptoms, GBS can be emotionally and physically devastating for patients and their families. It is often difficult for patients to adjust to sudden paralysis and dependence on others for help with daily activities. Patients may benefit from psychological counseling to help them cope.

The signs and symptoms of GBS can be quite varied, and several disorders present similar symptoms, making GBS difficult to diagnose. Physicians will note whether the symptoms appear on both sides of the body (most common in GBS) and the rate at which the symptoms spread (typically rapidly with GBS). Because signals traveling along the nerve are slower, a physician suspecting Guillain-Barré Syndrome may conduct a nerve conduction velocity test to test a patient’s reflexes. And because with GBS, the cerebrospinal fluid that bathes the spinal cord and brain contains elevated protein levels, a physician may perform a spinal tap, a procedure by which a small amount of cerebrospinal fluid is withdrawn for study.

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