Guillain Barre Syndrome

Overview

Guillain-Barré syndrome (say: ghee-yan bah-RAY) is a rare condition in which your body's immune system — its defense against germs — mistakenly attacks the nerves outside your brain and spinal cord. This can cause tingling, weakness, and sometimes temporary paralysis. It usually starts in your legs and can spread upward. The condition can be serious, but most people recover with treatment.

No. Guillain-Barré syndrome is rare. It affects about 1 to 2 people in every 100,000 each year. That means a typical GP (family doctor) might see only one or two cases in an entire career.

GBS can happen to anyone, at any age. It is slightly more common in adults, especially men. Many people who get GBS had a recent infection, but most people who have an infection do not develop the condition.

Symptoms

Common symptoms

• Tingling or 'pins and needles' feelings in the fingers, toes, or feet.
• Gradual weakness in your legs that may spread to your arms and upper body.
• Difficulty walking, climbing stairs, or standing up from a chair.
• An unsteady, wobbly feeling, as if your legs are 'giving way'.
• Facial weakness, including drooping eyelids or trouble making facial expressions.
• Double vision or difficulty moving your eyes.
• Pain that can feel like aching, soreness, or cramps in the back, arms, or legs.
• Difficulty speaking, chewing, or swallowing (later signs).

Symptoms in children

• Children may complain of leg pain, and they may have an unsteady walk or refuse to walk at all.
• They might be unusually irritable or tired, and may not be able to bear weight on their legs.
• Watch for a child who suddenly has trouble climbing stairs, getting off the floor, or buttoning clothes.

Symptoms in older adults

• Older adults tend to have more severe symptoms and may take longer to recover.
• They may already have other health conditions, such as diabetes or heart disease, that can affect recovery.
• Falls are a big risk, so extra care is needed with walking and moving around.

Causes

Main causes

• The exact cause is not fully understood, but GBS is an autoimmune condition: your immune system mistakenly attacks the protective covering of your nerves (called myelin), and sometimes the nerve fibers themselves.
• Most cases happen a few days or weeks after a bacterial or viral infection. Common triggers include a cold, the flu, a stomach infection (such as Campylobacter), or viruses like Epstein-Barr (the virus that causes glandular fever).
• Much less often, GBS can follow surgery or (in extremely rare cases) a vaccination.

Risk factors

• Recent infection, especially a respiratory infection or stomach bug.
• Age: it is more common in adults over 50, but can happen at any age.
• Being male — men are slightly more affected than women.
• Having a medical condition that affects your immune system — though this remains very rare.

When to see a doctor

See a doctor urgently if:

• Call your local emergency number now if you have trouble breathing, swallowing, or sudden weakness in your legs or arms.
• See a doctor the same day if you notice new tingling or weakness spreading from your feet into your legs, or if you keep falling.

Book a routine appointment if:

• Make an appointment if you have persistent tingling, unusual fatigue, or mild weakness after an illness, especially if it lasts more than a few days.
• Also see a doctor if you have achy pain in your back, arms, or legs along with a feeling of heaviness in your legs.

Diagnosis

A doctor can diagnose GBS after a careful history and physical exam. They will ask about recent infections and your symptoms, and check your reflexes, strength, and sensation. Because GBS can look like other conditions, you will probably be referred to a neurologist (a brain and nerve specialist) and be seen in hospital for tests.

Tests that may be done

• Nerve conduction studies (NCS) — small, safe electrical pulses are used to see how well your nerves transmit signals.
• Electromyography (EMG) — a thin needle is inserted into muscles to measure their electrical activity.
• Lumbar puncture (also called a spinal tap) — a small sample of fluid from around your spinal cord is taken to look for protein levels that are typical in GBS.
• Blood tests — to rule out other causes and look for previous infections.
• An MRI scan of the spine — sometimes done to rule out other problems.

What to expect at your appointment

Diagnosis can take time, because GBS is not the only condition that causes these symptoms. Most people are admitted to hospital for tests and monitoring. This is important, because the condition can affect your breathing or heart rate, even if you feel okay at first.

Treatment

Treatment for GBS is most effective when started early. It usually happens in hospital, and some people need intensive care. The main goals are to calm the immune attack, support your body's vital functions, and help you regain strength through rehabilitation. There is no quick cure, but the right treatment gives you the best chance of a good recovery.

Self-care at home

• Follow your healthcare team's advice about rest and movement. Gentle stretching, with their permission, can help prevent stiffness.
• Stay well hydrated and eat small amounts of food if you can, or ask about supplements if swallowing is difficult.
• Rest as much as you need; your body uses a lot of energy to heal nerves.
• Ask for help with daily activities and avoid doing anything that exhausts you.

Medical treatments

Two main treatments are used for GBS. One is called plasma exchange, where some of your blood is removed and the liquid part (plasma) is replaced with a protein solution, to remove the antibodies that are attacking your nerves. The other is called immunoglobulin therapy, where you receive a concentrated mix of healthy antibodies through a drip. Both help reduce the immune attack and work best when started early. Your doctor will also manage pain, monitor your breathing, and watch for complications like blood clots. You may also need physical, occupational, and speech therapy during recovery.

When is surgery considered?

Surgery is not used to treat Guillain-Barré syndrome. In rare cases, a procedure called tracheostomy (a small tube placed in the airway) may be needed to help with breathing while the nerves recover, but this is a care procedure, not a treatment for the condition itself.

Living with this condition

Recovery from GBS is often slow and can take weeks, months, or even a year or more. During the early phase, you may need to use a wheelchair, walker, or other support to move around. Safe your energy and don't push too hard. Your rehabilitation team will help you set small, realistic goals as you regain strength.

Lifestyle tips

• Use mobility aids and home modifications (like handrails, a raised toilet seat, a shower chair) to prevent falls.
• Break tasks into small steps and take rest breaks between activities.
• Ask family and friends for help with shopping, cooking, and cleaning while you recover.
• Set a daily routine that includes gentle activity, rest, and time outdoors if possible.

Diet and exercise

Eat a balanced diet with plenty of fruits, vegetables, lean protein, and whole grains to support nerve repair. Drink enough fluids. Exercise should be gentle and guided by your physiotherapist — too much too soon may exhaust you, but staying still can cause stiffness and blood clots. As you get stronger, gradually increase your activity.

Mental health and emotional wellbeing

Living with GBS can be frightening, frustrating, and isolating. You might feel anxious about your recovery, or low and tearful. These feelings are normal. Talk to your healthcare team about how you're feeling — they can connect you with a counsellor or psychologist. Remember that you are not alone, and seeking emotional support is a sign of strength, not weakness. If you ever feel in crisis, contact your local mental health crisis line or go to your nearest emergency department.

Prevention

GBS cannot be directly prevented, because it's an unusual immune reaction. The best you can do is reduce your risk of infections by washing your hands regularly, avoiding close contact with people who are sick, and staying healthy. If you do get an infection, treat it as your doctor advises.

Vaccines

Vaccinations protect against many serious infections, and the link between vaccines and GBS is extremely rare — far lower than the risk of getting GBS after the actual infection itself. Still, if you have had GBS in the past, talk to your doctor before getting any vaccine, as they may recommend waiting a certain amount of time. This is a personal decision to make with your healthcare provider.

Screening programmes

There is no routine screening test for Guillain-Barré syndrome. It is diagnosed when symptoms appear, and early recognition and treatment offer the best outcome.

Complications

If left untreated

• Respiratory failure — weakness of the muscles that help you breathe can become life-threatening without emergency support.
• Blood clots in the legs (deep vein thrombosis) due to being immobile.
• Pressure sores, also called bedsores, from prolonged lying or sitting.
• Urinary tract infections from a bladder that isn't emptying properly.
• Permanent nerve damage or persistent disability, including chronic pain, fatigue, or weakness.

Long-term outlook

It's natural to feel worried, but try to hold onto hope. With modern treatment, most people with Guillain-Barré syndrome survive and many make a full or near-full recovery. Recovery often takes time — sometimes many months — but most people regain much of their strength and independence. Some may continue to have minor weakness or tiredness, but that doesn't prevent them from living a full life. Focus on today's progress, and let your healthcare team help you through the road ahead.

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