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Guillain–Barré syndrome (GBS) is a rare autoimmune disorder, affecting as many as 6,000 people each year in the United States, but its risk increases with age. In the U.S., it’s most commonly seen in adults 50 and older, according to the Centers for Disease Control and Prevention (CDC).
Here’s what you need to know about the syndrome, including how to spot the warning signs and the steps you can take to lower its likelihood.
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What is GBS?
GBS occurs when a person’s own immune system attacks the peripheral nerves, which are the nerves outside the brain and spinal cord. This leads to muscle weakness, numbness, tingling and paralysis.
It typically occurs after an infection, usually within one to six weeks of illness.
Campylobacter infection — a bacterial infection you can get from undercooked poultry, raw milk and untreated water — is one of the most common causes of GBS in the U.S., according to the CDC. But it’s not the only cause.
“Anything essentially that can lead to an immune response can cause [GBS],” says Brad Wright, a professor and chair of the Department of Health Services Policy and Management in the Arnold School of Public Health at the University of South Carolina. He developed GBS and has studied it since then.
Other causes of GBS can include:
- Common viral infections, such as flu and COVID-19
- Diarrhea or a respiratory illness
- Vaccination, though it’s rare
- Surgery, which is also a rare cause
When you have GBS, your immune system becomes overzealous and mistakenly attacks your own nerves, says Wright, who developed GBS in 2017 after having an upper respiratory infection. He received treatment and recovered but spent months after his hospital admission going to physical, occupational and speech therapies.
Common symptoms of GBS
Guillain-Barré syndrome causes muscle weakness or tingling that can come on suddenly, though experts say most people get better with treatment.
It tends to start in your feet and legs, and move up to your arms and face. Other warning signs include:
- Muscle pain in your legs and back
- Leg or facial muscle paralysis, or nearly complete paralysis
- Difficulty breathing due to chest muscle weakness
- Hard time swallowing or talking
- Vision difficulty or challenges moving your eyes
- Changes in walking, balance or coordination
GBS and older adults
The risk of developing GBS can be three to four times higher in older adults, data suggests. Still, it’s important to emphasize that the overall incidence is low, says Simon Thebault, an assistant professor and attending physician at McGill University. “There is evidence of an uptick in GBS over recent decades, but it remains rare, and the increase is not dramatic,” he adds.
What’s more, older adults who develop GBS have a higher risk of complications.
In a 2021 Neurohospitalist study of 130 adults with GBS, those over the age of 59 had a more severe disease when they were admitted to the hospital and had a worse prognosis three months after. Patients age 70 or older were more likely to experience these outcomes.
The higher risk of more severe GBS is likely due to many factors, Thebault says. Older adults experience a natural, age-related decline in their immune systems, making them more vulnerable to common GBS triggers such as viral infections. Aging can also change the structure and function of peripheral nerves, making older adults more susceptible to damage.
Finally, underlying health conditions that become more common with age, such as diabetes and heart disease, can complicate recovery from the syndrome, Thebault explains.
How GBS is diagnosed
Doctors may suspect GBS if you are experiencing acute, progressive weakness — especially after a viral illness. They will evaluate your medical history and symptoms, and conduct some physical and neurologic exams, such as:
- Electromyography (EMG), which involves inserting a small needle and electrode into your muscle. This shows the electrical activity of your muscle on a screen as you rest and contract it.
- Nerve conduction tests, which gauge the nerves that control your muscles.
- Spinal tap (or lumbar puncture), which draws cerebrospinal fluid (CSF) from your lower back using a needle.
- Magnetic resonance imaging (MRI) on your spine, which is a painless scan.
EMG testing can be normal in the first week of symptoms, so it may need to be repeated, explains Dr. Sami Khella, a neurology professor at the University of Pennsylvania School of Medicine and director of EMG at Penn Presbyterian Medical Center.
How GBS is treated
While there’s no cure for GBS, doctors can treat the condition using:
- Plasma exchange. Plasmapheresis involves drawing blood, filtering out antibodies that are attacking your nerves and then returning your blood to your body.
- Intravenous immunoglobulin therapy. This is when proteins are injected into you to counteract the antibodies that cause GBS.
According to Khella, these two treatments can shorten the duration of the illness. And because many GBS cases follow gastrointestinal and respiratory infections, Thebault says the best way to prevent the condition is to reduce your chances of those infections.
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