Nerve and damaged myelin sheath
Guillain-Barré syndrome destroys the protective covering of the peripheral nerves (myelin sheath), preventing the nerves from transmitting signals to the brain.
Guillain-Barré (gee-YAH-buh-RAY) syndrome is a rare disorder in which your body's immune system attacks your nerves. Weakness and tingling in your extremities are usually the first symptoms.
These sensations can quickly spread, eventually paralyzing your whole body. In its most severe form Guillain-Barré syndrome is a medical emergency. Most people with the condition must be hospitalized to receive treatment.
The exact cause of Guillain-Barré syndrome is unknown. But it is often preceded by an infectious illness such as a respiratory infection or the stomach flu.
There's no known cure for Guillain-Barré syndrome, but several treatments can ease symptoms and reduce the duration of the illness. Most people recover from Guillain-Barré syndrome, though some may experience lingering effects from it, such as weakness, numbness or fatigue.
Guillain-Barré syndrome often begins with tingling and weakness starting in your feet and legs and spreading to your upper body and arms. In about half of people with the disorder, symptoms begin in the arms or face. As Guillain-Barré syndrome progresses, muscle weakness can evolve into paralysis.
Signs and symptoms of Guillain-Barré syndrome may include:
- Prickling, pins and needles sensations in your fingers, toes, ankles or wrists
- Weakness in your legs that spreads to your upper body
- Unsteady walking or inability to walk or climb stairs
- Difficulty with eye or facial movements, including speaking, chewing or swallowing
- Severe pain that may feel achy or cramplike and may be worse at night
- Difficulty with bladder control or bowel function
- Rapid heart rate
- Low or high blood pressure
- Difficulty breathing
People with Guillain-Barré syndrome usually experience their most significant weakness within two to four weeks after symptoms begin.
Once thought to be a single disorder, Guillain-Barré syndrome is now known to occur in several forms. The main types are:
- Acute inflammatory demyelinating polyradiculoneuropathy (AIDP), the most common form in the U.S. The most common sign of AIDP is muscle weakness that starts in the lower part of your body and spreads upward.
- Miller Fisher syndrome (MFS), in which paralysis starts in the eyes. MFS is also associated with unsteady gait. MFS occurs in about 5 percent of people with Guillain-Barré syndrome in the U.S. but is more common in Asia.
- Acute motor axonal neuropathy (AMAN) and acute motor-sensory axonal neuropathy (AMSAN) are less common in the U.S. But AMAN and AMSAN are more frequent in China, Japan and Mexico.
When to see a doctor
Call your doctor if you have mild tingling in your toes or fingers that doesn't seem to be spreading or getting worse. Seek emergency medical help if you have any of these severe signs or symptoms:
- Tingling that started in your feet or toes and is now moving up your body
- Tingling or weakness that's spreading rapidly
- Difficulty catching your breath or shortness of breath when lying flat
- Choking on saliva
Guillain-Barré syndrome is a serious condition that requires immediate hospitalization because it can worsen rapidly. The sooner appropriate treatment is started, the better the chance of a good outcome.
The exact cause of Guillain-Barré syndrome isn't known. The disorder usually appears days or weeks after a respiratory or digestive tract infection. Rarely, recent surgery or immunization can trigger Guillain-Barré syndrome. Recently, there have been a few cases reported following infection with the Zika virus.
In Guillain-Barré syndrome, your immune system — which usually attacks only invading organisms — begins attacking the nerves. In AIDP, the most common form of Guillain-Barré syndrome in the U.S., the nerves' protective covering (myelin sheath) is damaged. The damage prevents nerves from transmitting signals to your brain, causing weakness, numbness or paralysis.
Guillain-Barré syndrome can affect all age groups. But you're at slightly greater risk if:
- You're a man
- You're a young adult
Guillain-Barré syndrome may be triggered by:
- Most commonly, infection with campylobacter, a type of bacteria often found in undercooked poultry
- Influenza virus
- Epstein-Barr virus
- Zika virus
- Hepatitis A, B, C and E
- HIV, the virus that causes AIDS
- Mycoplasma pneumonia
- Hodgkin's lymphoma
- Rarely, influenza vaccinations or childhood vaccinations
Guillain-Barré syndrome affects your nerves. Because nerves control your movements and body functions, people with Guillain-Barré may experience:
- Breathing difficulties. The weakness or paralysis can spread to the muscles that control your breathing, a potentially fatal complication. Up to 30 percent of people with Guillain-Barré syndrome need temporary help from a machine to breathe when they're hospitalized for treatment.
- Residual numbness or other sensations. Most people with Guillain-Barré syndrome recover completely or have only minor, residual weakness, numbness or tingling.
- Heart and blood pressure problems. Blood pressure fluctuations and irregular heart rhythms (cardiac arrhythmias) are common side effects of Guillain-Barré syndrome.
- Pain. Up to half of people with Guillain-Barré syndrome experience severe nerve pain, which may be eased with medication.
- Bowel and bladder function problems. Sluggish bowel function and urine retention may result from Guillain-Barré syndrome.
- Blood clots. People who are immobile due to Guillain-Barré syndrome are at risk of developing blood clots. Until you're able to walk independently, taking blood thinners and wearing support stockings may be recommended.
- Pressure sores. Being immobile also puts you at risk of developing bedsores (pressure sores). Frequent repositioning may help avoid this problem.
- Relapse. Around 3 percent of people with Guillain-Barré syndrome experience a relapse.
Severe, early symptoms of Guillain-Barré syndrome significantly increase the risk of serious long-term complications. Rarely, death may occur from complications such as respiratory distress syndrome and heart attack.
Jan. 15, 2020