Guillain-Barré syndrome (GBS) is a rare disorder where the immune system attacks the nerves of the body, causing ascending paralysis that begins in the lower extremities and progresses upward. Symptoms include weakness, tingling, and difficulty walking or moving facial muscles. While there is no cure, treatments like plasmapheresis and immunoglobulin therapy can speed recovery, which usually takes 6-12 months but may last up to 3 years. Nurses play an important role in managing GBS by providing physical therapy, monitoring respiratory status, and avoiding infection during the recovery process.

1. Guillain-Barré Syndrome (GB)
Rare disorder in which immune system attacks nerves of the body
Acute infectious neuritis of the cranial and peripheral nerves.
Recovery can take years
Reversible
HALLMARK SIGN:
• Ascending paralysis (starts from the lower extremities and goes up)
• Paresthesia Weakness of the lower extremities Progressive weakness of the upper
extremities and facial muscles
• Weakness and tingling in your extremities are usually the first symptoms.
As the disease progresses, muscle weakness can evolve into paralysis.
Signs and symptoms of Guillain-Barre syndrome may include:
• Prickling, pins and needles sensations in your fingers, toes, ankles or wrists
• Weakness in your legs that spreads to your upper body
• Unsteady walking or inability to walk or climb stairs
• Difficulty with facial movements, including speaking, chewing or swallowing
• Double vision or inability to move eyes
• Severe pain that may feel achy, shooting or cramplike and may be worse at night
• Difficulty with bladder control or bowel function
• Rapid heart rate
• Low or high blood pressure
• Difficulty breathing
People with Guillain-Barre syndrome usually experience their most significant weakness within
two weeks after symptoms begin.
Types
Once thought to be a single disorder, Guillain-Barre syndrome is now known to occur in several
forms. The main types are:

2. • Acute inflammatory demyelinating polyradiculoneuropathy (AIDP) - The most
common sign of AIDP is muscle weakness that starts in the lower part of your body and
spreads upward.
• Miller Fisher syndrome (MFS), in which paralysis starts in the eyes. MFS is also
associated with unsteady gait.
• Acute motor axonal neuropathy (AMAN) and acute motor-sensory axonal
neuropathy (AMSAN)
Seek emergency medical help if you have any of these severe signs or symptoms:
• Tingling that started in your feet or toes and is now moving up your body
• Tingling or weakness that's spreading rapidly
• Difficulty catching your breath or shortness of breath when lying flat
• Choking on saliva
Risk Factors
• Most commonly, infection with campylobacter, a type of bacteria often found in
undercooked poultry
• Influenza 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
• Rarely, influenza vaccinations or childhood vaccinations
Complications
• Breathing difficulties. The weakness or paralysis can spread to the muscles that control
your breathing, a potentially fatal complication.
• Residual numbness or other sensations.

3. • Heart and blood pressure problems. Blood pressure fluctuations and irregular heart
rhythms (cardiac arrhythmias) .
• Pain. severe nerve pain, which may be eased with medication.
• Bowel and bladder function problems. Sluggish bowel function and urine retention.
• Blood clots. People who are immobile due to Guillain-Barre syndrome are at risk of
developing blood clots. Until you're able to walk independently, taking blood thinners and
wearing support stockings may be recommended.
• Pressure sores. Being immobile also puts you at risk of developing bedsores (pressure
sores). Frequent repositioning may help avoid this problem.
• Relapse. From 2% to 5% of people with Guillain-Barre syndrome experience a relapse.
• Rarely, death may occur from complications such as respiratory distress syndrome and
heart attacks.
Treatment
There's no cure for Guillain-Barre syndrome. But two types of treatments can speed recovery and
reduce the severity of the illness:
• Plasma exchange (plasmapheresis). The liquid portion of part of your blood (plasma) is
removed and separated from your blood cells. The blood cells are then put back into your
body, which manufactures more plasma to make up for what was removed. Plasmapheresis
may work by ridding plasma of certain antibodies that contribute to the immune system's
attack on the peripheral nerves.
• Immunoglobulin therapy. Immunoglobulin containing healthy antibodies from blood
donors is given through a vein (intravenously). High doses of immunoglobulin can block
the damaging antibodies that may contribute to Guillain-Barre syndrome.
Nurse’s responsibility
People with Guillain-Barre syndrome need physical help and therapy before and during
recovery. Your care may include:
• Movement of your arms and legs by caregivers before recovery, to help keep your muscles
flexible and strong

4. • Physical therapy during recovery to help you cope with fatigue and regain strength and
proper movement
• Training with adaptive devices, such as a wheelchair or braces, to give you mobility and
self-care skills
• Monitor respiratory status, autonomic dysreflexia, impaired mobility, cardiac status, gag
reflux
• Avoid infection
• Plasmaphoresis, immunoglobulin
• Prepare to initiate respiratory support (02, ventilation, incentive spirometer
Recovery timeline of Guillain-Barre syndrome
• After the first signs and symptoms, the condition tends to progressively worsen for about
two weeks
• Symptoms reach a plateau within four weeks
• Recovery begins, usually lasting six to 12 months, though for some people it could take
as long as three years
Among adults recovering from Guillain-Barre syndrome:
• About 80% can walk independently six months after diagnosis
• About 60% fully recover motor strength one year after diagnosis
• About 5% to 10% have very delayed and incomplete recovery