What Is Guillain-Barré Syndrome?

Medically Reviewed by Poonam Sachdev on March 14, 2024
6 min read

Guillain-Barré Syndrome (GBS) is a rare disorder in which your immune system suddenly attacks your nerves, often after you've had a stomach or respiratory bug.

Something that starts with a little tingling in your feet and hands can spread fast, causing muscle weakness and numbness, and in the worst cases, paralysis.

Most people recover, even after severe cases. But if you have the early symptoms of Guillain-Barré, you should get help quickly because it's a medical emergency.

Guillain-Barré syndrome has several types, including:

Acute inflammatory demyelinating polyradiculoneuropathy (AIDP). This is the most common type in North America and Europe. With this type, muscle weakness usually starts in your lower body and spreads upwards.

Miller Fisher syndrome (MFS). This is less common in the U.S. and more common in Asia. In this type, you may first have trouble moving your eyes. It also causes problems with coordination and balance.

Acute motor axonal neuropathy (AMAN) and acute motor-sensory axonal neuropathy (AMSAN). These are more common in China, Japan, and Mexico than in the U.S. Symptoms tend to be more severe and prolonged than in other types.

Doctors know GBS is not inherited or contagious. But it is linked to several infections, illnesses, and traumas. They don't know the exact cause.

It could be that some illnesses alter your nerve cells, so your immune system starts to view them as threats. Some scientists think your immune system forgets which cells it should and shouldn’t attack.

When you have it, your immune system begins attacking your nerves. In AIDP, which is the most common type of GBS, the nerves' protective covering (myelin sheath) is damaged. Sometimes, the core of the nerve, called an axon, is also damaged. The damage prevents nerves from sending signals between your brain and muscles. That means your muscles can't respond to your brain's commands, and your brain may get abnormal sensations from the damaged areas.

GBS can affect anyone. It's most common in people over age 50.

It's most often associated with a recent digestive or respiratory infection, and less often with other illnesses, surgery, trauma, or vaccines. About two-thirds of people who develop Guillain-Barré have diarrhea or respiratory symptoms in the days or weeks before nervous system symptoms start.

Some potential GBS triggers include:

  • Campylobacter, a type of bacteria found in undercooked poultry and thought to be the most common trigger
  • Influenza virus
  • COVID-19 virus
  • Cytomegalovirus
  • Epstein-Barr virus
  • Zika virus
  • Hepatitis A, B, C and E
  • HIV, the virus that causes AIDS
  • Mycoplasma pneumonia
  • Surgery
  • Trauma
  • Hodgkin's lymphoma
  • COVID-19 vaccines from Johnson & Johnson and AstraZeneca

While Guillain-Barré is more common after exposure to these things, it's not clear why these triggers are linked to this condition and why some people, but not most, get GBS after an infection or other medical event.

Guillain-Barré syndrome strikes quickly, often starting in your feet and legs. Sometimes, it starts with your face or arms.

Your symptoms might include:

  • Feeling "pins and needles" in your toes, ankles, fingers or wrists
  • Weakness that starts in your legs and moves upward
  • Unsteady walking
  • Trouble climbing stairs
  • Problems with speaking, chewing, swallowing, or other facial movements
  • Double vision
  • Trouble moving your eyes
  • Severe aching, shooting, or cramping pains that often worsen at night
  • Trouble controlling your bladder or bowels
  • Rapid heart rate
  • High or low blood pressure
  • Chest muscle weakness, making it difficult to breathe

Symptoms usually get worse over a few hours, days, or weeks. Most people are at their weakest 3 weeks after symptoms start. If you feel sudden weakness that gets worse over hours or days, or if you have trouble breathing or swallowing, are drooling, fainting, or feeling lightheaded when you stand, get medical help right away.

The symptoms of Guillain-Barré syndrome can resemble those of other neurological conditions. So, your doctor will likely go through a careful process to rule out other causes. That could include:

  • Asking how and when your symptoms started and whether you've had any recent illnesses
  • Doing a general physical exam
  • Doing a neurological exam, in which they check your mental state, speech, muscle strength, coordination, reflexes, balance, and sensitivity to touch

You will likely also get some tests including:

Spinal tap (lumbar puncture). Your doctor will insert a needle in your lower back to draw some fluid surrounding your spinal cord. A lab will test the fluid. High levels of protein in the fluid are linked to GBS.

Electromyography. To measure nerve activity in affected muscles, your doctor will insert very thin needle electrodes through the skin into the muscle.

Nerve conduction study. To measure the speed of nerve signals, the doctor will tape electrodes to the skin above the nerves and deliver a small shock.

Imaging tests. You might get an MRI of your spine or brain.

If you’re diagnosed with GBS, you should begin treatment right away. You can expect to be hospitalized in the intensive care unit.

Treatments that can speed your recovery or reduce the severity of your illness include:

Plasma exchange (plasmapheresis). A machine separates your plasma, the liquid part of your blood, from blood cells, and then it returns the blood cells and replacement fluids to your body. That stimulates your body to make new plasma. The process may filter out antibodies in your plasma that are attacking nerves.

Immunoglobulin therapy. You’ll get high doses of healthy antibodies from someone else through an IV. These help lessen your immune system’s attack on your body.

You might need additional treatments, including:

  • Pain medications
  • Drugs to prevent blood clots, which can happen when you don't move much
  • IV fluids to prevent dehydration if you are struggling to swallow
  • Tube feeding to keep you nourished if you can't eat as usual
  • A breathing tube, if you temporarily lose the ability to breathe on your own, which happens in up to 30% of cases

As you recover, you may move to a rehabilitation facility, where you might get:

  • Physical therapy to regain strength and movement and manage pain and stiffness
  • Occupational therapy to improve your ability to do daily tasks safely
  • Speech therapy to regain swallowing and speaking abilities
  • Mobility aids such as canes, braces, walkers, and wheelchairs to use as long as you need them 

What to expect 

After your first symptoms, you are likely to get worse for about 2 weeks and reach your weakest point within 2 weeks.

Most people then start to recover but can still feel weak and need a wheelchair or walker for a while. Usually, recovery takes 6-12 months; though for some people, it can take 3 years.

Among adults with the condition:

  • About 80% can walk without help after 6 months.
  • About 60% fully recover muscle strength within 1 year.
  • About 5%-10% have a very delayed and incomplete recovery.

Children rarely get GBS, but when they do, they usually recover more quickly than adults.

Guillain-Barré syndrome life expectancy

Once you recover from GBS, you have a normal life expectancy. Fewer than 2% of people die during the worst part of the illness. When people do die, it's usually because of pneumonia, a blood infection, breathing problems, blood clots, or cardiac arrest.





During treatment for Guillain-Barré syndrome, you might get:

  • Breathing problems
  • Shortened tissues in your joints (contractures) or other deformities
  • Blood clots that form when you're inactive
  • Infections
  • Low or unstable blood pressure
  • Paralysis
  • Pneumonia
  • Pressure sores, or bed sores (skin damage from lying in bed for a long time)
  • Breathing food or fluids into your lungs (aspiration)

Your health care team will try to prevent these complications. For example, frequently repositioning you in bed can help prevent pressure sores. And taking blood-thinning drugs and wearing support stockings can help prevent blood clots.

Some people face longer-term challenges. Those who don't recover completely can continue to have weakness, numbness, fatigue, or pain, for years. This is sometimes called chronic inflammatory demyelinating polyneuropathy. Treatment can include steroid medicines and physical therapy.

In an estimated 1%-6% of cases, people who've recovered from GBS have a relapse, meaning symptoms return, sometimes years later. Younger patients who had mild cases, or Miller-Fisher syndrome, are at the highest risk.

If you notice tingling, weakness, or numbness in your feet or legs starting to move up your body or problems with your facial muscles, you could have the telltale symptoms of Guillain-Barré syndrome. Getting medical help quickly can help you recover faster with fewer complications. In most cases, you'll fully recover.