What are the signs and symptoms of Guillain-Barré Syndrome (GBS)?

From the Guidelines

Guillain-Barré syndrome (GBS) typically presents with progressive muscle weakness, numbness and tingling, loss of reflexes, pain, autonomic dysfunction, and difficulty with eye movements, facial expressions, speaking, chewing, or swallowing, with symptoms progressing over hours to days and reaching maximum severity within 2-4 weeks 1. The key signs and symptoms of GBS include:

• Progressive muscle weakness: Usually starts in the legs and can spread to the arms and face
• Numbness and tingling: Often begins in the fingers and toes, spreading upward
• Loss of reflexes: Deep tendon reflexes are often absent or diminished
• Pain: Muscle or nerve pain, particularly in the back and legs
• Autonomic dysfunction: Can include changes in blood pressure, heart rate, and bladder/bowel function
• Difficulty with eye movements, facial expressions, speaking, chewing, or swallowing in some cases
• In severe cases, paralysis of respiratory muscles leading to breathing difficulties These symptoms can vary in severity and progression, with some patients experiencing a more rapid onset and others a more gradual decline 1. It is essential to note that GBS can present with various clinical variants, including pure motor, pure sensory, and Miller Fisher syndrome, among others 1. Early recognition and monitoring of disease progression are crucial, as GBS can be life-threatening if breathing muscles are affected or if autonomic dysfunction occurs 1. The exact cause of GBS is unknown, but it often follows a viral or bacterial infection, triggering an autoimmune response against peripheral nerves 1. Regular assessment and monitoring of respiratory function, muscle strength, and autonomic dysfunction are necessary to prevent complications and improve outcomes in patients with GBS 1.

From the Research

Signs and Symptoms of Guillain-Barré Syndrome (GBS)

The signs and symptoms of GBS include:

• Rapidly progressive and generally ascending symmetrical muscle weakness, accompanied by decreased or absent osteotendinous reflexes 2
• Progressive symmetrical weakness with areflexia in bilateral lower extremities 3
• Ascending symmetrical limb weakness, sensory disturbances, and absent or reduced deep tendon reflexes 4
• Autonomic dysfunction, which can occur in up to two-thirds of patients 4
• Respiratory insufficiency, which can develop in about 25% of patients 5
• Areflexic weakness, progressing over 4 weeks or less 6

Clinical Forms of GBS

There are 4 clinical forms of GBS:

• Acute inflammatory demyelinating polyradiculoneuropathy
• Acute motor axonal neuropathy
• Acute sensory and motor axonal neuropathy
• The Miller-Fisher variant, which is characterized by ophthalmoplegia, ataxia, and areflexia, with little muscle weakness 2

Diagnosis and Treatment

Diagnosis of GBS is based on clinical grounds, but lumbar puncture and electrophysiological studies can help to substantiate the diagnosis and to differentiate demyelinating from axonal subtypes of GBS 5. Treatment of GBS depends on the degree of severity, and may include intravenous immunoglobulin, plasma exchange, and other therapies 2, 5, 6