Medical Q&As

Guillain-Barré syndrome - prognosis?

A relative of mine was recently diagnosed with Guillain-Barré syndrome. He is a young man in his thirties and is currently on a life-support machine. What is the likely outcome for him?

Guillain-Barré syndrome is also known as Landry’s ascending paralysis and acute inflammatory demyelenating polyneuropathy. It is a disorder of the peripheral nerves, which means it involves the nerves outside of the brain and spinal cord. The onset of the illness can be quite dramatic and frightening for the person and their relatives. It begins with increasing weakness of the muscles in the legs that spreads to involve all of the voluntary muscles. The weakness can be accompanied by abnormal sensations, which are directly attributable to the nerve damage. Essentially if a peripheral nerve is damaged signal transmission though that nerve can be altered giving rise to a wide range of sensory symptoms. Many people with Guillain-Barré syndrome require intensive care and may need to be put on a ventilator to maintain their breathing. Plasma exchange and high dose intravenous immunoglobulins help to shorten the course of the illness. The cause of the syndrome is not known although many people report having experienced a bout of minor illness in the days prior to the onset of the paralysis. It is thought that an autoimmune process is at work, which means that the body’s own immune system is targeted inwards against itself rather than the traditional stance of defending the body against an invader such as a bacterium or a virus. Despite the dramatic nature of the illness the prognosis is good with most people making a full and complete recovery within a few months. A minority of people may take up to eighteen months to recover with the assistance of intensive rehabilitation. Since your relative is in his thirties and presumably fit for his age you can afford to be optimistic about the outcome despite the current drama.