Guillain-Barré Syndrome (GBS) Frequently Asked Questions

A. GBS is a neurological disorder characterized by gradually increasing weakness of the legs and arms over a period of days to weeks. It is caused by damage to the protective covering of the nerves, called myelin. Symptoms are variable and may be mild to debilitating.

A. A patient with GBS typically presents with muscle weakness and abnormal sensations in the feet and legs which may ascent to the arms and upper body in a rapid fashion. Physical examination will usually show loss of reflexes, such as the knee and ankle jerk. Patients with CIDP typically experience symptoms over a period of several months, while symptoms in patients with GBS usually progress more quickly and people reach a critical period of illness within 2 to 3 weeks. In severe cases, breathing difficulty and/or paralysis may occur. For these patients hospitalization and placement on a ventilator may be required.

A. Although the exact cause is unknown, it is believed that the immune system, which is normally protective, perceives myelin as foreign and attacks it. Just what starts this process is not clear. Some patients are found to have abnormal proteins in their blood, and these may facilitate damage. The acute onset of symptoms helps to differentiate it from other diseases.

A. Plasmapheresis or IVIG is usually given as soon as a diagnosis of GBS is established in an effort to stop the ascending paralysis before it compramises the patients respiration. In some patients, only a few courses of IVIG are needed to control symptoms and avoid significant disablity. Clinical evidence exists to support the use of IVIG to treat patients with GBS.[1]

1. Donofrio PD, Berger A, Brannagan TH 3rd, et al.Consensus statement: the use of intravenous immunoglobulin in the treatment of neuromuscular conditions report of the AANEM ad hoc committee. Muscle Nerve. 2009 Nov;40(5):890-900.