Information From Your Health Care Provider

GUILLAIN-BARRÉ SYNDROME

(Infectious Polyneuropathy)

Basic information

description

Guillain-Barré is a rare, inflammatory condition involving the peripheral nerves. These are nerves outside the brain and spinal column. It causes rapid weakness and loss of sensation. Guillain-Barré can affect all ages but is more common in young adults and the elderly.

FREQUENT SIGNS & SYMPTOMS

Muscle weakness or tingling starting in the lower limbs (feet and legs) and ascending (moving up) to the abdomen and chest, and to the arms and hands. The weakness spreads over days to weeks.
Facial weakness and drooping, double vision, difficulty in speaking and in swallowing.
Pain, often in the back and legs; muscle cramps and tenderness; numbness, tingling, or burning sensations.
Irregular heartbeat, high or low blood pressure.
Shortness of breath.
Complete paralysis (sometimes) for weeks or months.

causes

Unknown. It may be an autoimmune disorder. It sometimes follows a bacterial or viral infection.

risk increases with

Recent illness, such as a respiratory infection or gastroenteritis (stomach flu).

PREVENTIVE MEASURES

Cannot be prevented at present.

expected outcomes

Complete recovery without any lasting effects in many cases. Adults recover better than children. For some persons, symptoms clear in 15 to 20 days. Others require a year or more. Many mechanical devices can aid mobility until the person recovers.
Some patients will have moderate lasting effects, and a few will have severe disabilities.

possible complications

A relapse may occur after initial improvement.
Respiratory failure.
Permanent muscle weakness or numbness.
Permanent total or partial paralysis (rare).
Pneumonia.
Deep vein thrombosis.
Contractures of joints.

diagnosis & treatment

general measures

Your health care provider may be able to diagnose the disorder by the symptoms and with a physical exam. Medical tests may be done, such as lumbar puncture for spinal fluid analysis, electromyography (studying nerve and muscle disorders by recording electrical activity of muscles), and lung function tests.
Hospital care is needed in an intensive care unit so the condition can be closely monitored. There is no specific treatment for the disorder. Care involves supportive measures and methods to help speed recovery.
A respirator (breathing machine) may be needed if muscles of respiration become greatly weakened. A tracheotomy (opening in the throat for breathing) may be required.
Immunotherapy may be used to help shorten the duration and severity of the disease. It involves either plasmapheresis or IV immune globulin (injections).
Plasmapheresis is a procedure where blood plasma is withdrawn from the patient, treated to remove antibodies, and then returned to the body by transfusion.
Rehabilitation will begin as soon as it is feasible. It may involve physical therapy, occupational therapy (to promote self-care), speech therapy (to help with speaking and swallowing problems), and recreational therapy (helps the patient adjust to any disability).
To learn more: GBS-CDIP Foundation, Holly Building, 104 ½ Forrest Ave., Narberth, PA 19096; (866) 224-3301; website: www.gbs-cidp.org.

medications

IVIG (IV immune globulin) may be prescribed.
Drugs as needed for symptoms, such as pain.

activity

Remain as active as muscle strength permits. Have a family member or physical therapist passively move and stretch muscles.
Ongoing physical therapy will be needed to rebuild strength.