Overview

Symptoms

Guillain-Barré syndrome usually affects the feet or hands first, before spreading to other parts of the body.

It often starts a few days or weeks after an infection, such as a stomach bug or flu.

Early symptoms

Symptoms of Guillain-Barré syndrome 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
• pins and needles
• muscle weakness
• pain
• problems with balance and co-ordination

These symptoms usually affect both sides of the body at the same time.

Later symptoms

The symptoms may continue to get worse over the next few days or weeks.

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

• difficulty walking without assistance
• an inability to move the legs, arms and/or face (paralysis)
• difficulty breathing
• blurred or double vision
• difficulty speaking
• problems swallowing or chewing
• difficulty peeing, and constipation
• persistent and/or severe pain

Guillain-Barré syndrome usually reaches its most severe point within four weeks. It may then remain stable for a few weeks or months before gradually improving.

Get medical help

See your GP if you notice any of the early symptoms of Guillain-Barré syndrome, such as numbness or weakness.

Call 999 for an ambulance or go to your nearest accident and emergency (A&E) department immediately if someone:

• has difficulty breathing, swallowing or speaking
• can't move their limbs or face
• faints and doesn't regain consciousness within two minutes

This is a medical emergency and the person needs to be seen in hospital as soon as possible.

Read more about how Guillain-Barré syndrome is diagnosed and how Guillain-Barré syndrome is treated.

Who can get it

Diagnosis

Guillain-Barré syndrome can be difficult to diagnose because several other conditions can cause similar symptoms.

Your GP will refer you to a hospital specialist if they think you might have it or they aren't sure what's causing your symptoms.

Some of the main checks and tests you may need are outlined below.

Examination

Your GP or specialist may:

• ask about your symptoms, such as how long they've lasted and whether they're getting worse – muscle weakness that's getting worse over time is a common sign of Guillain-Barré syndrome
• examine your hands, feet or limbs to check for symptoms such as numbness
• ask if you've recently been ill – Guillain-Barré syndrome often follows an infection such as food poisoning or flu
• check your reflexes, such as whether your leg twitches when your knee is tapped in a particular place – people with Guillain-Barré syndrome usually have no or reduced reflexes

Nerve tests

In hospital, two tests may be carried out to see how well your nerves are working.

These are:

• electromyography (EMG) – tiny needles are inserted into your muscles and electrical recordings are taken to see how they react when nearby nerves are activated
• nerve conduction studies – small discs (electrodes) are stuck on your skin and minor electric shocks are used to activate the nerves and measure how quickly these signals travel along them

In people with Guillain-Barré syndrome, these tests will usually show that signals aren't travelling along the nerves properly.

Lumbar puncture

A lumbar puncture is a procedure to remove some fluid from around the spinal cord (the nerves running up the spine) using a needle inserted into the lower part of the spine.

The sample of fluid will be checked for signs of problems that can cause similar symptoms to Guillain-Barré syndrome, such as an infection.

Read more about what happens during a lumbar puncture.

Treatment

Treatment for Guillain-Barré syndrome can help reduce the symptoms and speed up recovery.

Most people are treated in hospital and usually need to stay in hospital for a few weeks to a few months.

The main treatments are outlined below.

Intravenous immunoglobulin (IVIG)

The most commonly used treatment for Guillain-Barré syndrome is intravenous immunoglobulin (IVIG).

When you have Guillain-Barré syndrome, the immune system (the body's natural defences) produces harmful antibodies that attack the nerves.

IVIG is a treatment made from donated blood that contains healthy antibodies. These are given to help stop the harmful antibodies damaging your nerves.

IVIG is given directly into a vein. Most people need treatment once a day for around five days.

Plasma exchange (plasmapheresis)

A plasma exchange, also called plasmapheresis, is sometimes used instead of IVIG.

This involves being attached to a machine that removes blood from a vein and filters out the harmful antibodies that are attacking your nerves before returning the blood to your body.

Most people need treatment every other day for a week or two.

Read more about the plasma exchange procedure.

Other treatments

While in hospital, you'll be closely monitored to check for any problems with your lungs, heart or other body functions.

You'll also be given treatment to relieve your symptoms and reduce the risk of further problems. This may include:

• a breathing machine (ventilator) if you're having difficulty breathing
• a feeding tube if you have swallowing problems
• painkillers if you're in pain
• being gently moved around on a regular basis to avoid bed sores and keep your joints healthy
• a thin tube called a catheter in your urethra (the tube that carries urine out of the body) if you have difficulty peeing
• laxatives if you have constipation
• medication and/or special leg stockings to prevent blood clots

Once you start to improve, you may also need extra support to aid your recovery.

Recovery

Most people eventually make a full recovery from Guillain-Barré syndrome, but this can sometimes take a long time and around 1 in 5 peopel have long-term problems.

The vast majority of people recover within a year.

A few people may have symptoms again years later but this is rare.

Possible long-term problems

These can include:

• being unable to walk without assistance – some people need to use a wheelchair
• weakness in your arms, legs or face
• numbness, pain or a tingling or burning sensation
• balance and co-ordination problems
• extreme tiredness

Support and rehabilitation

Specialised services are available to help you recover and adapt to any long-term problems.

This may involve support from:

• a physiotherapist – who can help with movement problems
• an occupational therapist – who can identify problem areas in the person's everyday life and work out practical solutions
• a speech and language therapist – who can help with communication and swallowing problems
• a counsellor – who you can discuss your problems with and who can help you find ways to cope emotionally

Your health and care needs will be assessed and an individual care plan drawn up to meet those needs. This should involve a discussion with you and anyone likely to be involved in your care.

See the carers section for information and advice about caring for someone.

Support groups

If you have Guillain-Barré syndrome, or you're caring for someone who has, you may find it useful to get in touch with a support group.

The main UK-based support group is GAIN (Guillain-Barré & Associated Inflammatory Neuropathies). You can visit their website for information or contact their helpline on 0800 374803.

You can also ask the healthcare professionals caring for you about support groups in your area.