Guillain-Barré syndrome

Symptoms

Guillain-Barré syndrome affects your senses, your movement and things such as breathing and your heartbeat.

It usually affects your arms and legs first before you get symptoms in other parts of your body.

Symptoms usually get worse over the first 2 to 4 weeks.

You might feel tingling, numbness or pins and needles in your feet and hands first. This is usually followed by muscle weakness and difficulty moving your joints.

Other symptoms can include:

• sharp, shooting pain (nerve pain), often in your legs or back
• problems breathing
• problems with your face, such as drooping face muscles or trouble swallowing or speaking
• problems with your eyes, such as double vision

Some people’s symptoms become so severe that they are not able to move their legs, arms and face (paralysis).

Important:
Some of the symptoms are common and may be caused by another condition.
Having these symptoms does not definitely mean you have Guillain-Barré syndrome. But it's important to get medical help so your symptoms can be checked.

Causes

It's not known what causes Guillain-Barré syndrome, but it's thought to be caused by problems with the immune system.

It usually starts within a few weeks of an infection, such as flu or a stomach bug.

When you get an infection, your immune system normally attacks and kills the bacteria or virus. But in Guillain-Barré syndrome the immune system starts to attack your nerves.

Guillain-Barré syndrome can affect anyone, but it's more common in adults and males.

Diagnosis

If you have symptoms of Guillain-Barré syndrome, your GP will check your reflexes and will check for any numbness or weakness in your muscles.

If a GP thinks you could have Guillain-Barré syndrome, they'll refer you to a specialist in nerve conditions (neurologist) for tests and treatment. You may have tests such as:

• an electrical test of your nerves and muscles
• a breathing test (spirometry)
• blood tests
• a lumbar puncture, where a sample of fluid is taken from the spine for testing

Treatment Options

If you've been diagnosed with Guillain-Barré syndrome, you'll be treated in hospital straight away. You'll usually be in hospital for several weeks. Some people may need to stay for several months.

Your main treatment will be immunotherapy to stop your immune system from attacking your nerves. You'll either have intravenous immunoglobulin (IVIG) or plasma exchange.

You'll also have treatment to help manage your symptoms and monitor your condition. You might need:

• medicine and compression stockings to reduce the risk of deep vein thrombosis (DVT), if you cannot walk
• medicines for pain such as gabapentin, carbamazepine or amitriptyline
• to be on a ventilator, if you have severe breathing problems – this would be in an intensive care unit (ICU)

When To See A Doctor

Contact your specialist straight away if:

• you have long-term symptoms that are getting worse
• you've recovered from Guillain-Barré syndrome and you start having symptoms again

Call an ambulance or go to emergency department if:

• you have problems with your face muscles, such as one side of your face drooping (falling lower than the other side) or trouble swallowing
• you’re not able to lift one or both arms
• you have trouble speaking, such as slurring your words

These could be signs of a stroke and need urgent medical attention.

Do not drive to emergency department. Ask someone to drive you or call and ask for an ambulance.
Bring any medicine you take with you.