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Guillain-Barré syndrome symptoms: What are the early signs of Guillain-Barré syndrome?

Medically reviewed by Jesse P. Houghton, MD, FACG
Fellow of the American College of Gastroenterology
Updated Oct. 27, 2023  •  Published Jun. 2, 2023
Fact Checked
Guillain-Barré syndrome symptoms

Overview: What does Guillain-Barré syndrome feel like?

Guillain-Barré syndrome (GBS) is a rare but serious autoimmune disorder in which the body’s immune system attacks peripheral nerves. It is usually triggered by a bacterial or viral infection. These infections often involve a pathogen such as Campylobacter jejuni or the Zika virus that has molecules very similar to the ones on the protective covering of nerve cells. When the body responds to the infection, it mistakes this protective covering for an invading pathogen and destroys it. 

As the peripheral nerves weaken, people lose the ability to move muscles or feel. In mild cases, people feel numbness, tingling, pain, and weakness in their feet or hands. As the condition progresses, these symptoms can spread up the legs or arms. Muscles get weak or limp. Walking becomes difficult. Reflexes slow down. In the most severe cases, the muscles in the legs, arms, and rest of the body become limp and paralyzed. Sometimes the face, mouth, and throat are affected. In the worst cases, the autonomic nervous system is affected. Blood pressure runs out of control, the heart beats abnormally, and breathing muscles don’t work. Though Guillain-Barré syndrome can be a serious and potentially life-threatening condition, most symptoms peak in two to four weeks and go away on their own, with most people fully recovering.

Key takeaways:

  • Guillain-Barré syndrome is a rare health condition that can affect anyone regardless of age, sex, race, or ethnicity. 

  • Early signs of Guillain-Barré syndrome include numbness, tingling, weakness, pain, and “pins and needles” sensations in the feet and hands.

  • Serious symptoms of Guillain-Barré syndrome such as paralysis, difficulty breathing, difficulty swallowing, or problems speaking may require immediate medical attention.

  • Guillain-Barré syndrome is caused by the body’s immune system and is usually triggered by a viral or bacterial infection. Healthcare professionals have not identified any risk factors other than these certain types of infections.

  • Guillain-Barré syndrome requires a medical diagnosis.

  • Guillain-Barré syndrome symptoms typically resolve with or without treatment within a few weeks and full recovery occurs within a few months.

  • Treatment of Guillain-Barré syndrome (when needed) may include hospitalization, intensive care, intravenous immunoglobulin (IVIG), plasma exchange, pain medications, mechanical ventilation, supportive care, and physical therapy.

  • Untreated severe Guillain-Barré syndrome could result in complications like breathing problems, heart rhythm abnormalities, and death.

  • Save on prescriptions for Guillain-Barré syndrome with a SingleCare prescription discount card.

What are the early signs of Guillain-Barré syndrome?

The signs of Guillain-Barré syndrome typically start in the hands, feet, and limbs on both sides of the body:

  • Numbness

  • Tingling or “pins and needles”

  • Pain

  • Weakness

Other Guillain-Barré syndrome symptoms

The symptoms of Guillain-Barré syndrome involve a gradual weakening of the peripheral nerves:

  • Weakness, limpness, and paralysis that gradually moves up the body on both sides 

  • Gradual loss of sensation as well as numbness and tingling that also moves up the body on both sides

  • Slowed or absent reflexes

  • Pain (affects about 50% to 89% of people with Guillain-Barré)

  • Weird or painful sensations

  • Facial weakness or paralysis

Severe symptoms of GBS include:

  • Difficulty swallowing

  • Trouble talking

  • Inability to breathe (about 30% of patients)

  • Orthostatic hypotension (drop in blood pressure when standing)

  • Urinary retention

  • Constipation

  • Erratic blood pressure

  • Heart rhythm irregularities (arrhythmias)

One very rare subtype of Guillain-Barré syndrome is called Miller Fisher syndrome. It differs from Guillain Barré in that it starts with the upper body. Because the head and face are involved, common symptoms of Miller-Fisher include:

  • Double or blurred vision

  • Drooping eyelids

  • Difficulty moving the eyes

  • Balance problems

  • Clumsiness when walking

  • Weakness or paralysis in the trunk or arms

Guillain-Barré syndrome vs. multiple sclerosis (MS) symptoms

Guillain-Barré syndrome and multiple sclerosis are very similar diseases. Both involve the immune system attacking the protective coating around nerves called the myelin sheath. However, MS is a progressive, chronic condition that damages nerves in the brain and spinal cord. Guillain-Barré is an acute (temporary) condition that typically lasts a few weeks and damages the peripheral nervous system. Unlike MS, people with GBS usually recover without permanent disabilities within a few months. Only about 1 in 20 people who recover from Guillain-Barré get it a second time.

Guillain-Barré syndrome MS
Shared symptoms
  • Muscle weakness
  • Numbness, tingling, and other changes in sensation
  • Fatigue
  • Difficulty swallowing
  • Trouble speaking or forming words
  • Trouble breathing 
  • Constipation
  • Urinary urgency
  • Inability to breathe
  • Vision changes (Miller Fisher syndrome)
  • Balance problems (Miller Fisher)
  • Coordination problems (Miller Fisher)
  • Dizziness and vertigo (Miller Fisher)
Unique symptoms
  • Ascending, bilateral muscle weakness and paralysis
  • Slowed or absent tendon reflexes
  • Pain
  • Muscle tightness or cramps
  • Cognitive problems
  • Mood and emotional changes
  • Uncontrollable or inappropriate laughing or crying
  • Hearing problems
  • Sexual problems

RELATED: MS symptoms: What are the early signs of MS?

Types and stages of Guillain-Barré syndrome: How can I tell which one I have? 

Guillain-Barré syndrome comes in a variety of types. These include:

  • Acute inflammatory demyelinating polyradiculoneuropathy (AIDP): approximately 9 out of 10 people diagnosed with GBS are diagnosed with this type. AIDP involves the steady deterioration of the myelin sheaths that protect the long conductive fibers of peripheral nerve cells.

  • Acute motor axonal neuropathy: in this rare subtype, long fibers not only lose their protective sheath, but they’re also damaged as well. This is a more serious problem. People with the AMAN variant usually experience only muscle weakness and paralysis without changes in sensation. Reflexes can sometimes be normal.

  • Acute motor-sensory axonal neuropathy: because long fibers in the nerves are being damaged, people diagnosed with this rare type of GBS have a much more severe progression of symptoms and require a longer time to recover.

  • Miller Fisher syndrome: this variant primarily affects the upper body, particularly the face and head. Vision and eye problems are the distinguishing characteristic along with facial and trunk weakness. 

No matter what the variant, Guillain-Barré syndrome proceeds in three distinct stages:

  • In the first, progressive stage, symptoms progressively worsen over several days or a few weeks.

  • In the second, plateau stage, symptoms more or less remain the same for a few days or weeks—in some severe cases, symptoms may remain static for longer.

  • In the final, recovery stage, symptoms gradually improve until the person is fully recovered (80% of cases)

In some cases, pain and weakness may go on for months or years. In about 20% of patients, disabilities and symptoms may last for years.

When to see a doctor for Guillain-Barré syndrome symptoms

The speed and severity of Guillain-Barré syndrome are unpredictable. The disease can become quickly life-threatening, so see a healthcare professional when Guillain-Barré symptoms first appear. Emergency medical treatment is required if it’s hard to breathe or hard to swallow.

Healthcare professionals diagnose Guillain-Barré syndrome primarily from the symptoms, but a cerebrospinal fluid test and nerve conduction tests will confirm the diagnosis. Spinal fluid will be collected using a spinal tap (lumbar puncture), and the tests will look for certain types of antibodies. Nerve conduction is measured by electromyography (EMG). An EMG measures nerve conduction velocity, or how quickly the nerves conduct electricity. Slow nerve conduction is the cause of many of the symptoms of GBS. Other tests such as a spinal MRI may be used to rule out other medical conditions.

Complications of Guillain-Barré syndrome

Although GBS spontaneously resolves with or without treatment, several possible complications make it vital that people with GBS quickly get treatment. 3% to 5% of people die of GBS complications including: 

  • Difficulty swallowing that leads to choking or aspiration

  • Respiratory compromise (inability to breathe)

  • Arrhythmias (heart rhythm or heart rate irregularities)

  • Blood clots

  • Infections

Other less threatening complications include:

  • Urinary retention

  • Constipation

  • Pressure sores

  • Pain

About 20% of people who experience Guillain-Barré will have long-term problems such as:

  • Difficulty walking without assistance

  • Weakness

  • Numbness or other skin sensation problems

  • Pain

  • Fatigue

How to treat Guillain-Barré syndrome symptoms

Healthcare professionals usually treat Guillain-Barré syndrome in a hospital. This allows them to provide supportive care and monitor for possible life-threatening complications. 

There are only two treatments that reduce the duration of Guillain-Barré symptoms: antibody injections and plasma exchange (plasmapheresis). Antibody injections, called immunoglobulin therapy, help to normalize the body's immune system and slow down its attacks on peripheral nerve cells. In plasma exchange, blood is slowly removed from the body. The fluid part of the blood, plasma, is then separated from blood cells and replaced by “clean” plasma that does not have antibodies that target the nerves. Both treatments are most successful when started soon after symptoms appear.

Supportive care will consist of monitoring, pain medications, blood thinners to prevent blood clots, and the use of a ventilator if breathing is compromised.

After the crisis has passed, physical therapy may be necessary to regain muscle movement, range of motion, and normal breathing. Pain medications may also be prescribed.

RELATED: Neuropathy treatments and medications

Signs Guillain-Barré syndrome is getting better

Even in bad cases, a few days or weeks after the peak, problems caused by Guillain-Barré, such as weakness and numbness improve. Full recovery may take months, but most people are better six months after the start of the disease. However, disability or minor symptoms may go on for a few years in a small group of people. 

Most importantly, get medical treatment

When Guillain-Barré symptoms first appear, what happens over the next few days or weeks is unpredictable. The early symptoms could develop into a mild case or a life-threatening one. For this reason, if Guillain-Barré symptoms are noticed, get medical attention as soon as possible. A healthcare provider may admit you to a hospital for monitoring, just in case. Additionally, the only proven treatments that shorten the duration of Guillain-Barré syndrome work best when started early.

FAQs about Guillain-Barré syndrome symptoms

Can COVID give you Guillain Barré syndrome?

Guillain-Barré syndrome is the most common complication of COVID-19 infection, but is still relatively rare. Additionally, there is some evidence that COVID-19 vaccination may increase the risk of developing Guillain-Barré syndrome, however this has not yet been proven. 

RELATED: 14 COVID myths—and the facts

Does Guillain-Barré syndrome ever go away?

In most people, Guillain-Barré syndrome spontaneously resolves within a few weeks. Full recovery usually requires longer than that, but most people do fully recover. About 1 in 5 people who have Guillain-Barré syndrome will have long-term disabilities or problems. 

What are the stages of Guillain-Barré syndrome?

Guillain-Barré syndrome follows a generally predictable course, though the severity and duration of the symptoms are hard to predict. In its first, progressive stage, symptoms appear and gradually get worse. Symptoms usually hit their worst in a few days to four weeks. This is followed by a plateau stage in which symptoms neither worsen or get better. After a few days, weeks, or months, people will enter a recovery phase. The time to full recovery will vary but usually takes a few months. About 20% of people who recover from Guillain-Barré will have long-term disabilities or other problems.

What’s next? Additional resources for people with Guillain-Barré syndrome symptoms

Test and diagnostics

Treatments

Scientific studies and clinical trials

Medically reviewed by Jesse P. Houghton, MD, FACG
Fellow of the American College of Gastroenterology

Jesse P. Houghton, MD, FACG, was born and raised in New Jersey, becoming the first physician in his entire family. He earned his medical degree from New Jersey Medical School (Now Rutgers Medical School) in 2002. He then went on to complete his residency in Internal Medicine and his fellowship in Gastroenterology at the Robert Wood Johnson University Hospital in 2005 and 2008, respectively. He moved to southern Ohio in 2012 and has been practicing at Southern Ohio Medical Center as the Senior Medical Director of Gastroenterology since that time.

Dr. Houghton is the author of What Your Doctor Doesn't (Have the Time to) Tell You: The Gastrointestinal System. He is also an Adjunct Clinical Associate Professor of Medicine at the Ohio University School of Osteopathic Medicine. He has been in practice since 2008 and has remained board-certified in both Internal Medicine and Gastroenterology for his entire career. He has lent his expertise to dozens of online articles in the medical field.

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