Guillain-Barré syndrome is an acute autoimmune disease usually triggered by a respiratory or gastrointestinal infection. The body's immune response to the infection is misdirected against the covering that insulates nerves, slowing or stopping nerve signals. NewYork-Presbyterian Hospital's neurologists work closely with other medical specialists, including emergency medicine personnel (since many Guillain-Barré patients come through the Emergency Department) to evaluate and treat patients. Together they offer comprehensive care to manage symptoms and speed recovery.
Over the course of days to weeks, patients with Guillain-Barré experience worsening weakness, which usually starts in the legs, progresses to the arms and upper body and can become severe. The muscles that control breathing may also be affected, causing patients to have difficulty breathing. Many patients with Guillain-Barré syndrome are hospitalized and may remain there for days to months.
Guillain-Barré may be challenging to diagnose because its symptoms resemble those of other diseases. NewYork-Presbyterian physicians employ a variety of tests to make an accurate diagnosis:
- Physical and neurological examination
- Spinal tap
- Electrodiagnostic tests (such as electromyography) which evaluate muscle and nerve function
Our doctors treat Guillain-Barré syndrome with two forms of therapy that can lessen the severity of symptoms and accelerate recovery:
- Plasmapheresis, a procedure in which doctors filter abnormal antibodies from the blood. Plasmapheresis is effective for relieving the symptoms of muscle weakness and fatigue and speeds recovery.
- High-dose immunoglobulin therapy (IVIg), in which patients receive infusions of immune proteins derived from normal donors; this treatment can weaken the immune system's attack on the nervous system and speed recovery.
Guillain-Barré syndrome can advance rapidly and become life-threatening, so it is best treated in a setting where patients are under constant observation and where any neurological deterioration can be quickly detected and treated. NewYork-Presbyterian Hospital's state-of-the-art Neurological Intensive Care Units (Neuro-ICUs) at NewYork-Presbyterian/Columbia University Medical Center and NewYork-Presbyterian/Weill Cornell Medical Center feature specially trained physicians and nurses, sophisticated monitoring techniques, and specialized treatments in 24-hour monitored settings.
Rehabilitation is integral to recovery from Guillain-Barré syndrome. Most patients eventually recover from even the most severe cases, though some continue to have a weakness. Patients usually begin rehabilitation while still in the hospital, and may continue working with rehabilitation specialists for some time, depending on the extent and duration of their weakness. NewYork-Presbyterian Hospital therapists evaluate muscle strength and motor skills, develop an individualized exercise and rehabilitation program for each patient, recommend equipment for the patient's home to ensure safety and mobility, and discuss ways to modify activities, conserve energy, and simplify work.
Studies are underway to expand our understanding of the development of Guillain-Barré syndrome and to develop more effective ways to treat it.