Guillain-Barré syndrome

Guillain-Barré syndrome

Guillain-Barré syndrome (pronounced ‘ghee-yan bar-ray’) is a rare condition where your immune system attacks your nerves. It can be serious, but it’s treatable, and many people can make a full recovery.

What causes Guillain-Barré syndrome?

The condition is triggered when your immune system works incorrectly and attacks and damages your nerves instead of fighting germs. Doctors don’t know exactly why this happens, but it often appears after a chest infection (like flu) or digestive tract infection (like gastroenteritis).

It can affect anyone, but men are more likely to get it. Your chances of developing the condition increase as you get older.

Symptoms

You might experience:

• Tingling and weakness, first appearing in your feet and hands and then travelling to your arms and legs

• A prickly sensation, or pins and needles, in your fingers, toes, wrists or ankles

• Weakness in your muscles

• Difficulties with balance and coordination

• Aching or shooting pain and cramps

• Vision problems

• Breathing difficulties

• Problems chewing, swallowing and speaking

Symptoms often worsen for the first few weeks after they appear and usually level off within four weeks.
See a doctor if you’re experiencing numbness or weakness. Call an ambulance if you’re having problems breathing, swallowing or speaking - this is a medical emergency.

How is Guillain-Barré syndrome diagnosed?

It can be challenging to diagnose Guillain-Barré syndrome because the signs and symptoms are similar to other conditions.

The doctor will start by asking you about any recent illnesses you’ve had and about your symptoms, especially whether the muscle weakness has worsened over time. They’ll also look at your hands, feet and limbs and check your reflexes.

If they suspect it’s Guillain-Barré syndrome, the doctor will refer you to a specialist for more tests. These might include:

• Electromyography (EMG) – Testing how well your nerves are working by taking electrical recordings of your muscle activity when nearby nerves are stimulated

• Nerve conduction studies – Small electric shocks activate the nerves, and doctors measure their speed

• Lumbar puncture – A sample of fluid is taken from around the spinal cord and analysed

Guillain-Barré syndrome treatment

Many people with Guillain-Barré syndrome make a full recovery after six to 12 months. A small proportion of people with the condition take as long as three years to recover. In rare cases, a full recovery is never made.

The following treatments can help speed up recovery and treat symptoms:

• Intravenous immunoglobulin (IVIG) – This is the most common treatment, where donated blood containing healthy antibodies is injected intravenously into your vein

• Plasma exchange (plasmapheresis) – Blood is removed from your body, and the harmful antibodies are filtered out before it’s returned

You’ll usually stay in the hospital for at least a few weeks to have these treatments. The doctors will closely monitor your lungs and heart during this time. Other treatments you may receive include:

• Painkillers

• A ventilator to help with any breathing difficulties

• Medicine or leg stockings to prevent blood clots

• A feeding tube to help with swallowing problems

• A catheter (a thin tube to carry urine out of your body)

Guillain-Barré syndrome complications

A small number of people develop long-term problems as a result of Guillain-Barré syndrome. This might include ongoing weakness, numbness and pain in the arms, legs or face, problems with balance and coordination, and difficulties walking.

In these cases, the doctor will be able to explain what support and rehabilitation are available. For example:

• A physiotherapist to help with physical movement

• An occupational therapist to help with daily life

• A speech and language therapist if you’re having problems with speech or swallowing

Ongoing difficulties like these can be difficult to cope with emotionally. You may also need support to help you manage these feelings. Talk to the doctor about counselling if you think you could benefit from speaking to someone about the impact of your condition on your mental health.