Guillain–Barré syndrome

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Guillain–Barré syndrome (GBS) is a rare, rapid-onset autoimmune disorder. The immune system mistakenly attacks the nerves outside the brain and spinal cord, causing weakness that usually starts in the feet and hands and moves upward. The progression happens over hours to weeks, and many people reach their worst weakness within a few weeks.

Common early signs are numbness, tingling, or pain in the legs, followed by weakness that spreads to the arms. In some cases, the muscles used for breathing weaken, which can require breathing support. Problems with parts of the autonomic nervous system, such as heart rate or blood pressure, can also occur.

Most cases are triggered by an infection, such as a stomach or chest illness, about 1–3 weeks before symptoms begin. In rare situations, surgery or vaccination has been linked. The exact cause isn’t fully understood, but the condition involves the immune system attacking nerve fibers or their protective coating (myelin).

Diagnosis is based on symptoms and tests. Important tests include nerve conduction studies and a lumbar puncture (spinal tap). The spinal fluid often shows high protein with a normal cell count (albuminocytological dissociation).

Treatment centers on two main therapies: intravenous immunoglobulin (IVIG) and plasmapheresis (plasma exchange). Both treatments help speed recovery. Steroids alone have not shown a clear benefit. People with GBS need careful hospital monitoring, and some require intensive care and ventilation.

Recovery can take weeks to years. Most people improve, but some have lasting weakness or fatigue. About 5–7% of people with GBS die, usually from complications. Younger people and those with milder initial weakness tend to have better outcomes.

There are several forms of GBS. The most common is the demyelinating type (AIDP); others affect the axons directly (AMAN/AMSAN), and Miller Fisher syndrome is a related variant with eye movement problems, ataxia, and absent reflexes.

Rehabilitation after the acute phase is important and typically includes physical, occupational, and sometimes speech therapy. Support from healthcare teams and patient groups helps many people cope with and overcome the condition.