Guillain-Barré Syndrome

Diagnosis

Guillain-Barré syndrome (GBS) can be difficult to diagnose in the earliest stages. GBS is called a syndrome rather than a disease because there is no specific disease-causing agent. Rather, the collective symptoms (what the patient feels) and signs (what the doctor can observe or measure) characterize the syndrome. Signs and symptoms vary from person to person.

The first step in diagnosing GBS is a comprehensive examination to help the doctor understand the signs and symptoms that the patient is experiencing. The medical history includes recent illnesses, surgeries (medical or dental) and vaccinations. The patient will have a complete physical exam, during which the doctor will be checking for signs of muscle weakness and loss of reflexes, such as knee jerk.

These tests may be ordered to uncover signs of GBS:

Spinal Tap (Lumbar Puncture)

This procedure involves inserting a needle into the spine, usually at the low back (lumbar) level. The test is used to determine the pressure of the cerebrospinal fluid (CSF). A sample of spinal fluid will be checked for evidence of an elevated protein.

Electromyogram (EMG or Electromyography)

This test helps to determine if there is a lack of nervous stimulation, meaning the peripheral nerves are not communicating between the brain and muscles in the body. In an EMG, a specially-trained physician inserts a thin-needle electrode into the muscle to be tested and places electrodes on the skin over peripheral nerves.

Nerve Conduction Study (Electroneurograph)

Similar to electromyography, this test is used to measure electrical nerve impulses in muscles. Two electrodes are taped to the skin in the affected area of the patient's body. A small shock is passed through to measure the electrical impulses from one electrode to the other.

Echocardiogram (ECHO) or Electrocardiogram (ECG)

These tests record the activity of the heart. The ECHO test uses sound wave imaging to measure the heart's muscles, valve movement and blood flow. The ECG uses monitors on the chest to provide information about electrical activity in the heart, including the heart's rhythm. In some cases of Guillain-Barré syndrome, the heart may show abnormalities.