Treatment of Guillain-Barré syndrome (GBS) depends on how severe your symptoms are and whether complications start. The main treatment for GBS is immunotherapy, which includes plasma exchange or intravenous immune globulin (IVIG). Treatment is given in a hospital. It starts immediately after you have been diagnosed with GBS that is getting worse. Early intervention with either of these treatments appears to be effective and may reduce recovery time. Neither treatment is better than the other, and there is no benefit to combining these treatments.⁵

Additional treatment for symptoms of GBS may include:

• Easing your breathing problems, sometimes through the use of a breathing machine (ventilator).
• Monitoring your blood pressure and heart rate.
• Providing adequate nutrition if you have problems chewing and swallowing.
• Managing bladder and bowel problems.
• Using physical therapy to help maintain muscle strength and flexibility.
• Preventing and treating complications such as pneumonia, blood clots in the legs, or urinary tract infections.

Careful monitoring is very important during the early stages of GBS because breathing problems and other life-threatening complications can occur within 24 hours after symptoms first start.

• Admission to a hospital or intensive care unit is often needed when muscle weakness progresses quickly. Muscle weakness may rapidly affect the muscles that control breathing. In such cases, temporary use of a mechanical ventilator may be necessary to help you breathe until you can breathe on your own again.
• Careful outpatient monitoring may be enough in cases where significant muscle weakness has not developed. It is important to continue to watch closely for any signs that the condition is getting worse so that you can contact your doctor or hospital immediately.

You probably will need to be hospitalized if you:

• Are unable to move around on your own.
• Have significant paralysis.
• Have breathing problems.
• Have blood pressure problems or an abnormal, very fast, or very slow heart rate.

If possible, you will be referred to a medical center that has experience treating the illness.

Recovery

Recovery may take 3 to 6 months, sometimes longer-in some cases, up to 18 months. People who have severe muscle weakness may need to stay at a rehabilitation hospital to receive ongoing physical therapy and occupational therapy as their motor function returns. For those who stay at home, devices that help perform certain daily activities can be used until motor function and muscle strength return.

Physical therapy and regular exercise are needed throughout the recovery period to strengthen the weakened muscles. The therapy program can be made to fit your specific needs.

Although recovery can be slow, most people who have GBS eventually recover.

• Many people have some minor long-term effects, such as numbness in the toes and fingers. In most cases, these problems will not significantly interfere with your lifestyle.
• Up to 20% of people have permanent problems that tend to be more disabling, such as weakness or balance problems. These problems may interfere with daily activities.⁵
• About 3% to 8% of people who develop GBS die from complications of the illness, such as respiratory failure, infection (often pneumonia), or heart attack.⁶
• Up to 67% of people who get GBS have some problems with persistent fatigue.⁵

Relapses

Relapses or repeated episodes of GBS happen in about 5% to 10% of cases, and they may be very serious.⁷ If you have a relapse, aggressive treatment with plasma exchange or IV immune globulin may reduce the severity of the attack and prevent further relapses. If you have more than one relapse, treatment with other drugs may be needed.