 Guillain-Barré syndrome is a rare, serious neurological disorder. It is an autoimmune disease that affects the peripheral nervous system and can lead to weakness and paralysis that may last for months or years. Guillain-Barré syndrome (GBS) often appears after a respiratory infection or gastroenteritis, better known as food poisoning. Symptoms start within a few days or weeks after the infection. In rare cases, GBS may follow a vaccination. In the United States, around 1 in 100,000 people develop GBS each year. Experts do not know why this disease occurs in some people and not others. It is not inherited or contagious. This article explores the symptoms, causes, diagnosis, and treatment of GBS. It also looks at possible links with vaccinations.
GBS is a rare, serious autoimmune disease that can affect any part of the nervous system outside the brain and spinal cord. This is called the peripheral nervous system. An autoimmune disease causes the immune system to attack and destroy certain groups of healthy cells. In the case of GBS, it attacks the myelin sheaths of peripheral nerves. Myelin sheaths coat the axons of nerves. The myelin helps these long, thin extensions of nerve cells pass on messages. In some cases, GBS also attacks the axons themselves. The damage prevents the nerves from sending certain information, such as touch sensations, to the spinal cord and brain. This causes a feeling of numbness. In addition, the brain and spinal cord can no longer transmit signals back to the body, leading to muscle weakness. Anyone who develops unexplained tingling sensations and weakness should receive medical attention as soon as possible. Types of GBSGBS can take a number of forms. Acute inflammatory demyelinating polyradiculoneuropathy is the most common type of GBS in the U.S. Typically, the weakness begins in the lower part of the body and gradually moves upward to affect other areas. Miller Fisher syndrome is an acquired nerve disease and a variant of GBS. It represents around 5–10% of GBS cases in the U.S. This disease can lead to problems with walking and balance. It affects the eye muscles and tendon reflexes. Another rare form of GBS is acute motor axonal neuropathy, which causes sudden weakness in the limbs and sometimes trouble breathing. It may involve nerves in the head. A similar form of GBS is acute motor-sensory axonal neuropathy, which starts with sensory changes, such as tingling or numbness. Some types begin more slowly and involve ongoing symptoms. In chronic inflammatory demyelinating polyneuropathy, periods of weakness recur over a number of years. In multifocal motor neuropathy, weakness affects several muscles in a specific area of one or both arms or legs. Symptoms of GBS often start within 3 weeks of an infection. They usually begin with tingling and weakness in the feet and hands or pain in the legs or back. Children may have difficulty walking. The weakness sometimes begins in the upper body, but it usually starts in the lower legs and spreads up. In some cases, it may not spread beyond the legs. If the weakness extends beyond the legs, a person may develop:
The symptoms can worsen over several hours, days, or weeks. In 9 out of 10 cases, the symptoms are worse in the third week. After 4 weeks, the weakness is unlikely to worsen. As well as muscle weakness and tingling, nerve changes can lead to:
Anyone with these symptoms needs urgent medical attention. In some cases, people lose the use of their muscles, resulting in paralysis. And breathing problems and cardiovascular changes can be life threatening. GBS can have emotional effects as well. Adjusting to rapid paralysis and the need for help can be distressing. After 4 weeks, when the symptoms have peaked, they remain stable for a time and the nerves gradually heal. The exact causes of GBS are still unclear, but it often occurs after an infection. In rare cases, people have experienced it after a vaccination. It can affect anyone, but those aged over 50 years appear to have a higher risk. People have developed GBS after infection with:
One theory is that viral and bacterial infections change how the immune system reacts to the peripheral nerves. This results in the immune system misidentifying myelin and axons as a foreign substance and targeting them. In July 2021, the Food and Drug Administration (FDA) warned that there may be an increased risk of developing GBS in the 42 days after a Johnson & Johnson (Janssen) COVID-19 vaccine. This has been administered under emergency use authorization from the FDA. However, instances of GBS following this vaccine are rare. By July 12, healthcare staff had administered approximately 12.5 million doses of the vaccine, and there were reports of about 100 cases of GBS. There may be a historical link between vaccination and GBS. In 1976, there was a small increase in the risk of developing GBS following a vaccination against swine flu. However, the increase was by just 1 case per 100,000. Experts have looked at a possible link between GBS and flu vaccines, but the results have varied. At most, there may be 1–2 more cases of GBS than usual per million doses of these vaccines, according to the Centers for Disease Control and Prevention (CDC). The CDC adds that the risk of developing GBS after a case of the flu is probably higher than the risk of it following the vaccination. Get live updates on COVID-19 vaccines here. GBS can be difficult to diagnose, especially in its earlier phases. The symptoms vary between people, and they can resemble the symptoms of other neurological conditions. A doctor will consider:
They may also recommend the following tests:
There is currently no cure for GBS, but treatment can help manage it. One approach is immunoglobulin therapy, which involves receiving antibodies from a donor intravenously, through an IV. This may help reduce the autoimmune response. Another approach is plasma exchange, which involves removing blood and sending it through a machine that separates the plasma from the blood cells. This removes some of the antibodies that are attacking healthy cells and allows the body to regenerate its plasma. These two methods are equally effective, as long as a person receives them within 2 weeks of GBS symptoms appearing. Using both treatments does not appear to improve the outcome. When symptoms are severe, a person may need help with breathing, a heart monitor, and help preventing saliva or food from entering their airways. During recovery, a lack of movement can result in complications, such as blood clots. Receiving injected blood thinners can help prevent this. A physical therapist can also help. Later, a rehabilitation plan may include physical and other types of therapy to rebuild strength and restore mobility and other functions. A person may also benefit from counseling, as GBS can affect mental and emotional well-being. Some research has suggested that corticosteroid injections may help reduce the harmful immune response, but there is currently not enough evidence to support this. In most cases, the nerve damage from GBS worsens quickly for 2–3 weeks and stops worsening after 4 weeks. Some people experience paralysis, but most recover in 6–12 months. Here are some facts about the symptoms and recovery from the National Institute of Neurological Diseases and Stroke:
Recovery can take time, and a person will need support during this process. Overall, 1 in 20 cases of GBS is fatal, usually due to cardiovascular problems, breathing difficulty, or an infection. However, most people make a full recovery. GBS is a rare, serious neurological disease. It is an autoimmune condition that can arise after certain infections. Symptoms include tingling and muscle weakness. In some cases, it can lead to paralysis. Most people make a full recovery, but this can take time. There is currently no cure for GBS, but various treatments can reduce its impact. Anyone who believes that they have symptoms of GBS should receive medical attention immediately because the disease can lead to life threatening complications. Last medically reviewed on July 15, 2021 Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy. |
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