Guillain-Barré Syndrome

Guillain-Barré syndrome is a rare condition in which the immune system mistakenly attacks the peripheral nerves, causing rapidly progressive muscle weakness. It often follows a mild infection and, while serious, most people recover with prompt treatment.

• Weakness or tingling that typically begins in the legs and can spread upward to the arms and upper body over days
• Difficulty walking or climbing stairs
• In more severe cases, weakness of the muscles used for breathing or swallowing, which is a medical emergency
• Reduced or absent reflexes on examination
• Symptoms often follow a mild respiratory or gastrointestinal infection by one to a few weeks

• Results from an abnormal immune response, often triggered by a preceding infection, in which the immune system mistakenly attacks the coverings of peripheral nerves.
• Can follow various infections, including some gastrointestinal and respiratory infections.
• The exact reason why some people develop this abnormal immune response after infection while most do not is not fully understood.

• Suspected clinically based on the pattern of rapidly progressive, symmetrical weakness typically starting in the legs, together with reduced reflexes.
• Lumbar puncture, where available, often shows a characteristic pattern in the cerebrospinal fluid supporting the diagnosis.
• Nerve conduction studies, where available, can help confirm nerve involvement.
• Assessment of breathing function is essential, as respiratory muscle weakness can develop and requires close monitoring.

Guillain-Barré syndrome requires hospital admission for close monitoring, given the risk of rapid progression to breathing difficulty, which can require urgent respiratory support.

Specific treatments — such as intravenous immunoglobulin or plasma exchange, where available — can speed recovery and reduce the severity of the illness if started early.

Supportive care includes monitoring of breathing, heart rhythm, and blood pressure, as well as prevention of complications from prolonged immobility, such as blood clots and pressure sores.

Physiotherapy and rehabilitation support recovery of strength and function, which can take weeks to months, with most people making a good recovery over time.

• There is no specific way to prevent Guillain-Barré syndrome, since it is an unpredictable immune reaction to infection.
• Seek prompt medical assessment for rapidly progressive weakness, particularly following a recent infection, as early treatment improves outcomes.
• Anyone diagnosed should be monitored closely in hospital until the risk of breathing muscle involvement has passed.