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Alternative Names Return to topLandry-Guillain-Barre syndrome; Acute idiopathic polyneuritis; Infectious polyneuritis; Acute inflammatory polyneuropathy
Definition Return to top
Guillain-Barre syndrome is a serious disorder that occurs when the body's defense (immune) system mistakenly attacks part of the nervous system. This leads to nerve inflammation that causes muscle weakness, which continues to get worse.
Causes Return to top
Guillain-Barre syndrome is an autoimmune disorder (the body's immune system attacks itself). Exactly what triggers Guillain-Barre syndrome is unknown. The syndrome may occur at any age, but is most common in people of both sexes between ages 30 and 50.
It often follows a minor infection, usually a lung infection or gastrointestinal infection. Usually, signs of the original infection have disappeared before the symptoms of Guillain-Barre begin.
Guillain-Barre syndrome causes inflammation that damages parts of nerves. This nerve damage causes tingling, muscle weakness, and paralysis. The inflammation usually affects the nerve's covering (myelin sheath). Such damage is called demyelination. Demyelination slows nerve signaling. Damage to other parts of the nerve can cause the nerve to stop working.
Guillain-Barre syndrome may occur along with viral infections such as:
It may also occur with other medical conditions such as systemic lupus erythematosus or Hodgkin's disease.
Some people may get Guillain-Barre syndrome after a bacterial infection, certain vaccinations (such as rabies and swine flu), and surgery.
Symptoms Return to top
Symptoms of Guillain-Barre get worse very quickly. It may take only a few hours to reach the most severe symptoms.
Muscle weakness or the loss of muscle function (paralysis) affects both sides of the body. If the muscle weakness starts in the legs and then spreads to the arms, it is called ascending paralysis.
Patients may notice tingling, foot or hand pain, and clumsiness. As the loss of muscle function gets worse, the patient may need breathing assistance.
Typical symptoms include:
Additional symptoms may include:
Emergency symptoms (seek immediate medical help):
Exams and Tests Return to top
A history of increasing muscle weakness and paralysis may be a sign of Guillain-Barre syndrome, especially if there was a recent illness.
A medical exam may show muscle weakness and problems with involuntary (autonomic) body functions such as blood pressure and heart rate. The examination may also show that reflexes, such as the "knee jerk," are decreased or missing.
There may be signs of decreased breathing (caused by paralysis of the breathing muscles).
The following tests may be ordered:
Treatment Return to top
There is no cure for Guillain-Barre syndrome. However, many treatments are available to help reduce symptoms, treat complications, and speed up recovery.
When symptoms are severe, the patient will need to go to the hospital for breathing help, treatment, and physical therapy.
A method called plasmapheresis is used to clean a person's blood of proteins called antibodies. Blood is taken from the body, usually from the arm, pumped into a machine that removes the antibodies, then sent back into the body.
High-dose immunoglobulin therapy (IVIg) is another procedure used to reduce the severity and length of Guillain-Barre symptoms.
Other treatments are directed at preventing complications.
Support Groups Return to top
Guillain-Barre Syndrome Foundation International - www.gbsfi.com
Outlook (Prognosis) Return to top
Recovery can take weeks or years. Most people survive and recover completely. According to the National Institute of Neurological Disorders and Stroke, about 30 percent of patients still have some weakness after 3 years. Mild weakness may persist for some people.
A patient's outcome is most likely to be very good when the symptoms go away within 3 weeks after they first started.
Possible Complications Return to top
When to Contact a Medical Professional Return to top
Seek immediate medical help if you have any of the following symptoms:
References Return to top
Hughes RA, Raphael JC, Swan AV, van Doorn PA. Intravenous immunoglobulin for Guillain-Barre syndrome. Cochrane Database Syst Rev. 2006 Jan 25;(1):CD002063. Review.
Hughes RA, Wijdicks EF, Barohn R, et al. Practice parameter: immunotherapy for Guillain-Barre syndrome: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2003 Sep. 23;61(6):736-40.
Sharar E. Current therapeutic options in severe Guillain-Barre syndrome. Clin Neuropharmacol. 2006 Jan-Feb;29(1):45-51.
Roos, KL. Viral Infections. In: Goetz, CG, ed. Textbook of Clinical Neurology. 3rd ed. Philadelphia, PA: Saunders Elsevier; 2007: chap 41.Update Date: 6/4/2008 Updated by: Linda Vorvick, MD, Seattle Site Coordinator, Maternal & Child Health Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.