Guillain-Barré syndrome usually affects the feet or hands first, before spreading to other parts of the body.

It often starts a few days or weeks after an infection, such as a stomach bug or flu.

Early symptoms

Symptoms of Guillain-Barré syndrome usually develop over hours or days and tend to start in your feet and hands before spreading to your arms and legs.

At first you may have:

• numbness
• pins and needles
• muscle weakness
• pain
• problems with balance and co-ordination

These symptoms usually affect both sides of the body at the same time.

Later symptoms

The symptoms may continue to get worse over the next few days or weeks.

Some people are only mildly affected, but others may have:

• difficulty walking without assistance
• an inability to move the legs, arms and/or face (paralysis)
• difficulty breathing
• blurred or double vision
• difficulty speaking
• problems swallowing or chewing
• difficulty peeing, and constipation
• persistent and/or severe pain

Guillain-Barré syndrome usually reaches its most severe point within 4 weeks. It may then remain stable for a few weeks or months before gradually improving.

Get medical help

See a GP if you notice any of the early symptoms of Guillain-Barré syndrome, such as numbness or weakness.

Call 999 for an ambulance or go to your nearest accident and emergency (A&E) department immediately if someone:

• has difficulty breathing, swallowing or speaking
• cannot move their limbs or face

This is a medical emergency and the person needs to be seen in hospital as soon as possible.

Read more about how Guillain-Barré syndrome is diagnosed and how Guillain-Barré syndrome is treated.

Guillain-Barré syndrome is thought to be caused by a problem with the immune system, the body's natural defence against illness and infection.

Normally the immune system attacks any germs that get into the body. But in people with Guillain-Barré syndrome, something goes wrong and it mistakenly attacks the nerves.

This damages the nerves and stops signals from the brain travelling along them properly, which can cause problems such as numbness, weakness and pain in the limbs.

It's not clear exactly why this happens. The condition is not passed from person to person and is not inherited.

Possible triggers

Sometimes Guillain-Barré syndrome appears to have a particular trigger. These are some of the main triggers.

Infections

In most cases, Guillain-Barré syndrome occurs a few days or weeks after an infection.

Infections that have been known to trigger the condition include:

• food poisoning – especially if caused by Campylobacter bacteria
• flu
• cytomegalovirus – a common virus that does not usually cause any symptoms
• glandular fever
• HIV
• some tropical diseases, including dengue and the Zika virus

Vaccinations

In the past, vaccinations (particularly the flu vaccine used in the US during a swine flu outbreak in 1976) were linked to an increased risk of Guillain-Barré syndrome.

But research has since found the chances of developing the condition after having a vaccination are extremely small.

For example, a study into the vaccine used during the 2009 swine flu outbreak found that for every million people who had the vaccination, there were fewer than 2 extra cases of Guillain-Barré syndrome.

And evidence suggests that you are far more likely to get Guillain-Barré syndrome from an infection, such as the flu, than the vaccine designed to prevent the infection, such as the flu jab.

Guillain-Barré syndrome can be difficult to diagnose because several other conditions can cause similar symptoms.

A GP will refer you to a hospital specialist if they think you might have it or they are not sure what's causing your symptoms.

Examination

A GP or specialist may:

• ask about your symptoms, such as how long they've lasted and whether they're getting worse – muscle weakness that's getting worse over time is a common sign of Guillain-Barré syndrome
• examine your hands, feet or limbs to check for symptoms such as numbness
• ask if you've recently been ill – Guillain-Barré syndrome often follows an infection such as food poisoning or flu
• check your reflexes, such as whether your leg twitches when your knee is tapped in a particular place – people with Guillain-Barré syndrome usually have no or reduced reflexes

Nerve tests

In hospital, 2 tests may be carried out to see how well your nerves are working.

These are:

• electromyography (EMG) – tiny needles are inserted into your muscles and electrical recordings are taken to see how they react when nearby nerves are activated
• nerve conduction studies – small discs (electrodes) are stuck on your skin and minor electric shocks are used to activate the nerves and measure how quickly these signals travel along them

In people with Guillain-Barré syndrome, these tests will usually show that signals are not travelling along the nerves properly.

Lumbar puncture

A lumbar puncture is a procedure to remove some fluid from around the spinal cord (the nerves running up the spine) using a needle inserted into the lower part of the spine.

The sample of fluid will be checked for signs of problems that can cause similar symptoms to Guillain-Barré syndrome, such as an infection.

Treatment for Guillain-Barré syndrome can help reduce the symptoms and speed up recovery.

Most people are treated in hospital and usually need to stay in hospital for a few weeks to a few months.

Intravenous immunoglobulin (IVIG)

The most commonly used treatment for Guillain-Barré syndrome is intravenous immunoglobulin (IVIG).

When you have Guillain-Barré syndrome, the immune system (the body's natural defences) produces harmful antibodies that attack the nerves.

IVIG is a treatment made from donated blood that contains healthy antibodies. These are given to help stop the harmful antibodies damaging your nerves.

IVIG is given directly into a vein.

Plasma exchange (plasmapheresis)

A plasma exchange, also called plasmapheresis, is sometimes used instead of IVIG.

This involves being attached to a machine that removes blood from a vein and filters out the harmful antibodies that are attacking your nerves before returning the blood to your body.

Most people need treatment over the course of around 5 days.

Other treatments

While in hospital, you'll be closely monitored to check for any problems with your lungs, heart or other body functions.

You'll also be given treatment to relieve your symptoms and reduce the risk of further problems. This may include:

• a breathing machine (ventilator) if you're having difficulty breathing
• a feeding tube if you have swallowing problems
• painkillers if you're in pain
• being gently moved around on a regular basis to avoid bed sores and keep your joints healthy
• a thin tube called a catheter in your urethra (the tube that carries urine out of the body) if you have difficulty peeing
• laxatives if you have constipation
• medicine and/or special leg stockings to prevent blood clots

Once you start to improve, you may also need extra support to aid your recovery. Read more about recovering from Guillain-Barré syndrome.

Most people eventually make a full recovery from Guillain-Barré syndrome, but this can sometimes take a long time and around 1 in 5 people have long-term problems.

The vast majority of people recover within a year.

A few people may have symptoms again years later, but this is rare.

Possible long-term problems

These can include:

• being unable to walk without assistance – some people need to use a wheelchair
• weakness in your arms, legs or face
• numbness, pain or a tingling or burning sensation
• balance and co-ordination problems
• extreme tiredness

Support and rehabilitation

Specialised services are available to help you recover and adapt to any long-term problems.

This may involve support from:

• a physiotherapist – who can help with movement problems
• an occupational therapist – who can identify problem areas in the person's everyday life and work out practical solutions
• a speech and language therapist – who can help with communication and swallowing problems
• a counsellor – who you can discuss your problems with and who can help you find ways to cope emotionally

Your health and care needs will be assessed and an individual care plan drawn up to meet those needs. This should involve a discussion with you and anyone likely to be involved in your care.

See the care and support section for information and advice about caring for someone, including sections that may be useful if you're new to caring.

Support groups

If you have Guillain-Barré syndrome, or you're caring for someone who has, you may find it useful to get in touch with a support group.

The main UK-based support group is GAIN (Guillain-Barré & Associated Inflammatory Neuropathies). You can visit their website for information or contact their helpline on 0800 374803.

You can also ask the healthcare professionals caring for you about support groups in your area.