Guillain-Barre syndrome

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Superficial anterior muscles

Landry-Guillain-Barre syndrome; Acute idiopathic polyneuritis; Infectious polyneuritis; Acute inflammatory polyneuropathy; Acute inflammatory demyelinating polyneuropathy

Symptoms of Guillain-Barre can get worse very quickly. It may take only a few hours to reach the most severe symptoms, but weakness that increases over several days is also common.

Muscle weakness or the loss of muscle function (paralysis) affects both sides of the body. In most cases, the muscle weakness starts in the legs and then spreads to the arms. This is called ascending paralysis.

Patients may notice tingling, foot or hand pain, and clumsiness. If the inflammation affects the nerves to the diaphragm and chest and there is weakness in those muscles, the person may need breathing assistance.

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Typical symptoms include:

• Loss of reflexes in the arms and legs
• Low blood pressure or poor blood pressure control
• Muscle weakness or loss of muscle function (paralysis)
  • In mild cases, there may be weakness instead of paralysis
  • May begin in the arms and legs at the same time
  • May get worse over 24 to 72 hours
  • May occur in the nerves of the head only
  • May start in the arms and move downward
  • May start in the feet and legs and move up to the arms and head
• Numbness
• Sensation changes
• Tenderness or muscle pain (may be a cramp-like pain)
• Uncoordinated movement

Other symptoms may include:

• Blurred vision
• Clumsiness and falling
• Difficulty moving face muscles
• Muscle contractions
• Palpitations (sensation of feeling the heart beat)

Emergency symptoms (seek immediate medical help):

• Breathing temporarily stops
• Can't take a deep breath
• Difficulty breathing
• Difficulty swallowing
• Drooling
• Fainting
• Feeling light-headed when standing

A history of increasing muscle weakness and paralysis may be a sign of Guillain-Barre syndrome, especially if there was a recent illness.

A medical exam may show muscle weakness and problems with involuntary (autonomic) body functions, such as blood pressure and heart rate. The examination will also show that reflexes, such as the "ankle or knee jerk," are decreased or missing.

There may be signs of decreased breathing caused by paralysis of the breathing muscles.

The following tests may be ordered:

• Cerebrospinal fluid sample ("spinal tap")
• ECG
• Electromyography (EMG) tests the electrical activity in muscles
• Nerve conduction velocity test
• Pulmonary function tests

Review Date: 06/15/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).