Diagnosis
Guillain-Barre syndrome can be difficult to diagnose in its earliest stages. Its signs and symptoms are similar to those of other neurological disorders and may vary from person to person.
Your doctor is likely to start with a medical history and thorough physical examination.
Your doctor may then recommend:
- Spinal tap (lumbar puncture). A small amount of fluid is withdrawn from the spinal canal in your lower back. The fluid is tested for a type of change that commonly occurs in people who have Guillain-Barre syndrome.
- Electromyography. Thin-needle electrodes are inserted into the muscles your doctor wants to study. The electrodes measure nerve activity in the muscles.
- Nerve conduction studies. Electrodes are taped to the skin above your nerves. A small shock is passed through the nerve to measure the speed of nerve signals.
Treatment
There's no cure for Guillain-Barre syndrome. But two types of treatments can speed recovery and reduce the severity of the illness:
- Plasma exchange (plasmapheresis). The liquid portion of part of your blood (plasma) is removed and separated from your blood cells. The blood cells are then put back into your body, which manufactures more plasma to make up for what was removed. Plasmapheresis may work by ridding plasma of certain antibodies that contribute to the immune system's attack on the peripheral nerves.
- Immunoglobulin therapy. Immunoglobulin containing healthy antibodies from blood donors is given through a vein (intravenously). High doses of immunoglobulin can block the damaging antibodies that may contribute to Guillain-Barre syndrome.
These treatments are equally effective. Mixing them or administering one after the other is no more effective than using either method alone.
You are also likely to be given medication to:
- Relieve pain, which can be severe
- Prevent blood clots, which can develop while you're immobile
People with Guillain-Barre syndrome need physical help and therapy before and during recovery. Your care may include:
- Movement of your arms and legs by caregivers before recovery, to help keep your muscles flexible and strong
- Physical therapy during recovery to help you cope with fatigue and regain strength and proper movement
- Training with adaptive devices, such as a wheelchair or braces, to give you mobility and self-care skills
Recovery
Although some people can take months and even years to recover, most people with Guillain-Barre syndrome experience this general timeline:
- After the first signs and symptoms, the condition tends to progressively worsen for about two weeks
- Symptoms reach a plateau within four weeks
- Recovery begins, usually lasting 6 to 12 months, though for some people it could take as long as three years
Among adults recovering from Guillain-Barre syndrome:
- About 80% can walk independently six months after diagnosis
- About 60% fully recover motor strength one year after diagnosis
- About 5% to 10% have very delayed and incomplete recovery
Children, who rarely develop Guillain-Barre syndrome, generally recover more completely than adults.
Coping and support
A diagnosis of Guillain-Barre syndrome can be emotionally difficult. Although most people eventually recover fully, the condition is generally painful and requires hospitalization and months of rehabilitation. You must adjust to limited mobility and fatigue.
To manage the stress of recovery from Guillain-Barre syndrome, consider these suggestions:
- Maintain a strong support system of friends and family
- Contact a support group, for yourself or for family members
- Discuss your feelings and concerns with a counselor
Preparing for your appointment
You may be referred to a doctor who specializes in disorders of the brain and nervous system (neurologist).
What you can do
- Write down your symptoms, including any that may seem unrelated to the reason why you scheduled the appointment.
- Make a list of all your medications, vitamins and supplements.
- Write down your key medical information, including other conditions.
- Write down key personal information, including any recent changes or stressors in your life.
- Write down questions to ask your doctor.
- Ask a relative or friend to accompany you, to help you remember what the doctor says.
Questions to ask your doctor
- What's the most likely cause of my symptoms?
- What kinds of tests do I need?
- What kind of treatments do I need?
- How soon do you expect my symptoms to improve with treatment?
- How fully do you expect I'll recover?
- How long will recovery take?
- Am I at risk of long-term complications?
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask other questions during your appointment.
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may leave time to go over points you want to spend more time on. You may be asked:
- What are your symptoms, and what parts of your body are affected?
- When did you first begin experiencing symptoms? Did they start suddenly or gradually?
- Do your symptoms seem to be spreading or getting worse?
- If you are experiencing weakness, does it affect one or both sides of your body?
- Have you had problems with bladder or bowel control?
- Have you had any problems with vision, breathing, chewing or swallowing?
- Have you recently had an infectious illness?
- Have you recently spent time in a forested area or traveled abroad?
- Have you recently had any medical procedures, including vaccinations?