From the Guidelines
Paralysis in Guillain-Barré syndrome typically occurs within 2 weeks after symptom onset, with most patients reaching their maximum disability during this period. The clinical presentation of Guillain-Barré syndrome (GBS) is heterogeneous, but patients usually present with weakness and sensory signs in the legs that progress to the arms and cranial muscles 1. The disease progression can be rapid, and the paralysis usually begins in the lower extremities and ascends symmetrically upward, potentially affecting the trunk, upper limbs, and in severe cases, the respiratory muscles.
Key Points
- The paralysis results from immune-mediated damage to peripheral nerve myelin sheaths or axons, disrupting nerve signal transmission to muscles 1.
- Before paralysis develops, patients often experience paresthesias, numbness, and muscle weakness.
- The severity varies widely between individuals, with some experiencing mild weakness while others develop complete quadriplegia and respiratory failure requiring mechanical ventilation 1.
- After the acute phase, most patients enter a plateau phase lasting days to weeks, followed by a recovery phase that may extend from several months to years, during which nerve regeneration occurs and paralysis gradually improves 1.
Disease Course
The disease course of GBS can be divided into three phases: the acute phase, the plateau phase, and the recovery phase.
- The acute phase is characterized by a rapid progression of weakness and paralysis, usually reaching its maximum severity within 2-4 weeks after the initial symptoms appear 1.
- The plateau phase is a period of stability, during which the patient's condition does not worsen or improve significantly, and can last from days to weeks or months 1.
- The recovery phase is a period of gradual improvement, during which nerve regeneration occurs and paralysis gradually improves, and can extend from several months to years 1.
From the Research
Period of Paralysis in Guillain-Barré Syndrome
The period of paralysis in Guillain-Barré syndrome (GBS) is typically characterized by a progressive flaccid paralysis that can occur over a period of days or weeks.
- The exact timeline of paralysis can vary depending on the individual and the severity of the disease.
- Studies have shown that the majority of patients with GBS experience a rapid progression of symptoms, with some patients requiring mechanical ventilation within a few days of symptom onset 2, 3.
- The paralysis can progress to affect various parts of the body, including the respiratory, facial, and bulbar functions, and can lead to significant morbidity and mortality if left untreated 4, 5.
- Treatment with intravenous immunoglobulin (IVIg) or plasma exchange (PE) can help to hasten recovery and improve outcomes in patients with GBS, with some studies suggesting that IVIg may be associated with a slightly faster recovery time and reduced need for mechanical ventilation 3, 6.