Guillain-Barré Syndrome

Overview

GBS often develops days to weeks after a preceding infection. Weakness progresses over days to weeks, sometimes reaching respiratory muscles requiring ventilatory support. Most patients recover, though the degree of recovery varies. Prompt recognition and hospital-based treatment are critical. Dr. Jitendra Prasad Yadav evaluates and manages GBS patients in coordination with hospital and rehabilitation services.

Symptoms

• Rapidly progressive weakness starting in the legs and spreading upward
• Loss of deep tendon reflexes (areflexia)
• Tingling or numbness in the hands and feet
• Difficulty walking or climbing stairs
• Facial weakness or difficulty with eye closure (bilateral)
• Difficulty speaking, chewing, or swallowing in severe cases
• Breathing difficulty — a medical emergency requiring ICU care
• Autonomic symptoms — blood pressure fluctuations, heart rate changes, urinary retention

Causes

• Autoimmune attack on peripheral nerve myelin or axons following infection
• Common preceding infections: Campylobacter jejuni (gastroenteritis), cytomegalovirus, Epstein-Barr virus, influenza, Zika virus
• Vaccine-associated GBS is rare and typically milder than infection-associated cases
• The exact autoimmune trigger varies; molecular mimicry is the proposed mechanism

Risk factors

• Recent respiratory or gastrointestinal infection (within 1–6 weeks)
• Campylobacter jejuni infection (strongest association)
• Age — peak incidence in adults 30–50 and older adults
• Male sex slightly more common
• Rarely, recent vaccination or surgery

Diagnosis

Clinical presentation of rapidly progressive ascending weakness with areflexia. Lumbar puncture typically shows albuminocytological dissociation (elevated protein with normal cell count). Nerve conduction studies help classify the variant (demyelinating vs axonal). Dr. Jitendra assesses clinical progression and coordinates urgent investigations.

Treatment & management

Hospital-based care is essential. Immunotherapy — intravenous immunoglobulin (IVIG) or plasma exchange (plasmapheresis) — shortens the course. Supportive care includes respiratory monitoring, physiotherapy, blood pressure management, DVT prophylaxis, and psychological support. Rehabilitation is critical during recovery.

Management is individualized and discussed with benefits, limitations, and follow-up.

Prevention & self-care

No specific prevention exists. Prompt treatment of infections and awareness of warning symptoms (progressive weakness, tingling) allow early medical evaluation. Vaccination decisions are made on a case-by-case basis balancing GBS risk against the benefit of preventing the infection.

When to seek medical attention

• Rapidly progressive leg weakness over hours to days
• Numbness and tingling spreading upward from the feet
• Loss of ability to walk or climb stairs
• Difficulty breathing, speaking, or swallowing
• Loss of deep tendon reflexes
• Any progressive weakness after an infection

Frequently asked questions