From the Guidelines
Guillain-Barré syndrome (GBS) is primarily caused by an abnormal immune response that attacks the peripheral nerves, triggered by preceding infections such as Campylobacter jejuni, cytomegalovirus, Epstein-Barr virus, influenza, Zika virus, and COVID-19 1. The most common trigger is a preceding infection, typically occurring 1-3 weeks before GBS symptoms develop.
- Campylobacter jejuni, a bacterial infection causing gastroenteritis, is the most frequently identified pathogen, accounting for about 30% of cases.
- Other infectious triggers include cytomegalovirus, Epstein-Barr virus, influenza, Zika virus, and COVID-19.
- In rare cases, GBS can develop following vaccination, surgery, or trauma. The condition involves the immune system mistakenly attacking the myelin sheath or axons of peripheral nerves, leading to weakness, numbness, and paralysis that typically begins in the legs and can ascend to affect the arms and respiratory muscles. The exact mechanism involves molecular mimicry, where antibodies produced against infectious agents cross-react with components of peripheral nerve tissue due to structural similarities, as noted in a recent study 1. This autoimmune attack disrupts nerve signal transmission, resulting in the characteristic symptoms of GBS. Key points to consider in the diagnosis and management of GBS include early recognition, admission to the intensive care unit, treatment indication and selection, monitoring and treatment of disease progression, prediction of clinical course and outcome, and management of complications and sequelae, as outlined in a guideline for the diagnosis and management of GBS 1.
From the Research
Causes of Guillain-Barré Syndrome
The causes of Guillain-Barré syndrome (GBS) are complex and multifaceted. Some of the key factors that contribute to the development of GBS include:
- Preceding bacterial or viral infections, with Campylobacter jejuni being the most frequent antecedent pathogen 2, 3, 4, 5, 6
- Immune responses directed towards the infecting organisms, which can cross-react with neural tissues due to molecular mimicry 2, 3, 5, 6
- Autoantibody-mediated immune processes, which can trigger demyelination or axonal damage in peripheral nerves 3, 4, 5
Infectious Triggers
Some of the most common infectious triggers of GBS include:
- Campylobacter jejuni, which is responsible for about a third of GBS cases 5
- Mycoplasma pneumoniae 5
- Cytomegalovirus 4, 5
- Zika virus 3
- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) 3
Non-Infectious Triggers
While less common, non-infectious triggers can also contribute to the development of GBS, including: