HealthInfo Waitaha Canterbury

Guillain-Barré syndrome

Guillain-Barré syndrome is a disorder where your body's immune system attacks the covering of certain nerves (called myelin sheath). This causes damage to the nerves.

There are four types of Guillain-Barré syndrome:

• Acute inflammatory demyelinating polyradiculoneuropathy (AIDP)

  This is the most common form and usually starts with muscle weakness in the lower part of your body and spreads upward.

• Miller Fisher syndrome (MFS)

  In this form, the paralysis (loss of muscle function) starts in your eyes leading to double vision, droopy eyelids and uncoordinated or imbalance in movement.

• Acute motor axonal neuropathy (AMAN) and acute motor-sensory axonal neuropathy (AMSAN)

  These are rare and are the most severe types of Guillain-Barré syndrome.

Causes of Guillain-Barré syndrome

Doctors do not know the exact causes of Guillain-Barré syndrome but think it may be started by:

• food poisoning (particularly from Campylobacter bacteria)
• the flu
• viral infections
• childbirth
• surgery.

Guillain-Barré syndrome is not passed down from parent to child and you cannot catch it or pass it on to someone else.

Symptoms of Guillain-Barré syndrome

Symptoms usually develop over hours or days and tend to start in your feet and hands before spreading to your arms and legs.

At first you may have:

• numbness or tingling
• muscle weakness
• pain
• problems with balance and co-ordination.

These symptoms usually affect both sides of the body at the same time. They may continue to get worse over the next few days or weeks. They're usually at their worst within four weeks before gradually improving.

Some people are only mildly affected, but others may have:

• difficulty walking without help
• an inability to move their legs, arms or face
• difficulty breathing
• blurred or double vision
• difficulty speaking
• problems swallowing or chewing
• difficulty weeing and constipation.

A few people have severe symptoms, including their chest muscles being so weak that they need to be on a breathing machine (ventilator). They may be unable to swallow, so they need to be fed via a tube.

Diagnosing Guillain-Barré syndrome

Your doctor will ask when your symptoms started and how they have changed. They may ask if you've had any recent infections. Your doctor may also do tests, such as a lumbar puncture and a nerve conduction study (which measures how well and how quickly your nerves conduct electrical signals).

Treating Guillain-Barré syndrome

There is no cure for Guillain-Barré syndrome. It usually gets better slowly on its own over time, as the nerves repair themselves.

• Guillain-Barré syndrome is usually treated in hospital, where your breathing, heart rate and blood pressure can be carefully tracked.
• In severe cases, you may be treated with:
  • intravenous immune globulins, which are helpful antibodies that are added to your blood
  • plasma exchange, where blood is taken out of your body, the harmful antibodies are removed, then the blood is returned to your body.

  These treatments have been found to shorten the length of the illness.

Other health professionals may be involved in your treatment:

• Dietitians – including support to plan meals that are nutritious and help you maintain a healthy weight. Also, education about foods to keep your bowels regular and that are easier or safer for you to swallow.
• Occupational therapists – including help to support independence, including support with seating and positioning, managing fatigue and education about pacing.
• Pharmacists – including advice on medications to help with symptoms, what to do if you have any difficulty swallowing your medications and education about new medications on discharge from hospital.
• Physiotherapists – including physical therapy to improve balance, coordination, muscle strength and range of motion. Also, education about breathing exercises, coughing techniques and lying positions in bed.
• Social workers – including counselling and help to access support services in the community.
• Speech-language therapists – including help to make eating and drinking as safe as possible and help with communication.

Long‑term effects

Most people with Guillain-Barré syndrome make a full recovery in six to 12 months. But you may be in hospital for a few months. One or two in 10 people will be left with some degree of permanent problems, such as weakness, muscle wasting, difficulty walking or pain.

Managing fatigue and conserving energy are important during your recovery. Doing too much too early can delay your recovery.

  HealthInfo recommends the following pages

• Guillain Barré Syndrome Support Group NZ Trust

  The group supports people with Guillain-Barré syndrome and related conditions.

• Patient.info – Guillain-Barré Syndrome

  Information about Guillain-Barré syndrome including its causes, diagnosis and treatment.

Written by HealthInfo clinical advisers. Page created August 2023.

Sources

Page reference: 1139544

Review key: HIGBS-1139544