Unmasking Guillain-Barre Syndrome: From Triggers to Treatment


Authors : Shaik Parveen; D. Gowthami; P. Sanjana; N. Sharanya

Volume/Issue : Volume 10 - 2025, Issue 6 - June


Google Scholar : https://tinyurl.com/4mwyuw8f

DOI : https://doi.org/10.38124/ijisrt/25jun078

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.


Abstract : Guillain-Barre Syndrome (GBS) is rare yet serious acute immune-mediated polyneuropathy impacting peripheral nervous system, often occurring after an infection. It usually manifests as rapidly advancing, symmetrical weakness in the limbs, areflexia, and sensory disturbances of varying degrees. GBS encompasses various clinical forms, such as Acute Inflammatory Demyelinating Polyradiculoneuropathy (AIDP), Acute Motor Axonal Neuropathy (AMAN), as well as Miller Fisher Syndrome (MFS). From an epidemiological perspective, the global incidence of GBS is 0.89-1.89 cases per 100,000 person-years, with higher frequency observed among older adults and males. Infections, especially Epstein-Barr virus, cytomegalovirus, Campylobacter jejuni, as well as Zika virus, correlate with regional and seasonal variations. The pathogenesis includes molecular mimicry, where antibodies cross-react with gangliosides on peripheral nerves, leading to demyelination or axonal degeneration. The diagnosis is mainly clinical, corroborated by Nerve conduction studies (NCS), as well as analysis of Cerebrospinal fluid (CSF) that demonstrates albuminocytological dissociation. GBS constitutes a medical emergency because of the dangers of respiratory failure, autonomic dysfunction, and cranial nerve involvement. During the acute phase, supportive care such as respiratory monitoring, Deep-vein thrombosis (DVT) prophylaxis, and nutritional support is essential. During recovery, rehabilitation plays an important part, centring on the restoration of motor function, complication prevention, and enhancement of quality of life. Although the majority of patients recover, a subset continues to experience long-term disability and fatigue. It is essential to identify early, treat promptly, and manage with a multidisciplinary approach in order to achieve optimal outcomes. To enhance patient care and reduce long-term complications, ongoing investigation into immunopathogenesis and treatment approaches is essential.

Keywords : Acute Inflammatory Demyelinating Polyradiculoneuropathy, Acute Motor Axonal Neuropathy, Miller Fisher Syndrome, Nerve Conduction Studies, Deep Vein Thrombosis Prophylaxis.

References :

  1. Dhuli K, Naureen Z, Medori MC, Fioretti F, Caruso P, Perrone MA, Nodari S, Manganotti P, Xhufi S, Bushati M, Bozo D. Physical activity for health. Journal of preventive medicine and hygiene. 2022 Oct 17;63(2 Suppl 3): E150.
  2. Mingsheng LI, Liying CU. The changes in European Academy of Neurology/Peripheral Nerve Society guideline on diagnosis and treatment of chronic inflammatory demyelinating polyradiculoneuropathy. Chinese Journal of Neurology. 2022:181-6.
  3. Van den Berg B, Walgaard C, Drenthen J, Fokke C, Jacobs BC, Van Doorn PA. Guillain–Barré syndrome: pathogenesis, diagnosis, treatment and prognosis. Nature Reviews Neurology. 2014 Aug;10(8):469-82.
  4. Hadhiah K, Alhashim A, Al-Dandan HA, Alhassan E, Alqarni AM, Memish AA, Alabdali M. Guillain–Barré syndrome post-SARS-CoV-2 vaccine: a systematic review and data analysis on its clinical, laboratory, electrophysiological, and radiological features. Frontiers in Neurology. 2024 Jan 29; 15:1332364.
  5. Laman JD, Huizinga R, Boons GJ, Jacobs BC. Guillain-Barré syndrome: expanding the concept of molecular mimicry. Trends in immunology. 2022 Apr 1;43(4):296-308.
  6. Prineas JW. Pathology of the Guillain‐Barré syndrome. Annals of Neurology: Official Journal of the American Neurological Association and the Child Neurology Society. 1981;9(S1):6-19.
  7. Haymaker W, KEBNOHAN JW. The Landry-Guillain-Barré syndrome: a clinicopathologic report of fifty fatal cases and a critique of the literature. Medicine. 1949 Feb 1;28(1):59.
  8. Wachira VK, Peixoto HM, de Oliveira MRF. Systematic review of factors associated with the development of Guillain-Barre Syndrome 2007–2017: what has changed? Trop Med Int Health 2019; 24: 132–42.
  9. Yuki N, Susuki K, Koga M, et al. Carbohydrate mimicry between human ganglioside GM1 and Campylobacter jejuni lipooligosaccharide causes Guillain-Barre syndrome. Proc Natl Acad Sci USA 2004;101: 11404–09.
  10. Cao-Lormeau VM, Blake A, Mons S, et al. Guillain-Barre Syndrome outbreak associated with Zika virus infection in French Polynesia:a case-control study. Lancet 2016; 387: 1531–39.
  11. Alter M. The epidemiology of Guillain‐Barré syndrome. Annals of Neurology: Official Journal of the American Neurological Association and the Child Neurology Society. 1990;27(S1): S7-12.
  12. Madden J, Spadaro A, Koyfman A, Long B. High risk and low prevalence diseases: Guillain-Barré syndrome. The American Journal of Emergency Medicine. 2024 Jan 1; 75:90-7.
  13. Nguyen, T.P.; Taylor, R.S. Guillain-Barre Syndrome. In StatPearls; StatPearls Publishing: Treasure Island, FL, USA, 2023.
  14. Sejvar JJ, Baughman AL, Wise M, Morgan OW. Population incidence of Guillain-Barré syndrome: a systematic review and meta-analysis. Neuroepidemiology 2011; 36: 123–33.
  15. Dobson JL, McMillan J, Li L. Benefits of exercise intervention in reducing neuropathic pain. Frontiers in cellular neuroscience. 2014 Apr 4; 8:102.
  16. Simatos Arsenault N, Vincent PO, Yu BH, Bastien R, Sweeney A. Influence of exercise on patients with Guillain-Barré syndrome: a systematic review. Physiotherapy Canada. 2016;68(4):367-76.
  17. Levin KH. Variants and mimics of Guillain Barré syndrome. The Neurologist. 2004 Mar 1;10(2):61-74.
  18. Kiper P, Chevrot M, Godart J, Cieślik B, Kiper A, Regazzetti M, Meroni R. Physical Exercise in Guillain-Barré Syndrome: A Scoping Review. Journal of Clinical Medicine. 2025 Apr 12;14(8):2655.
  19. Elendu C, Osamuyi EI, Afolayan IA, Opara NC, Chinedu-Anunaso NA, Okoro CB, Nwankwo AU, Ezidiegwu DO, Anunaso CA, Ogbu CC, Aghahowa SO. Clinical presentation and symptomatology of Guillain-Barré syndrome: A literature review. Medicine. 2024 Jul 26;103(30): e38890.
  20. Walling AD, Dickson G. Guillain-barré syndrome. American family physician. 2013 Feb 1;87(3):191-7.
  21. Van Doorn PA, Ruts L, Jacobs BC. Clinical features, pathogenesis, and treatment of Guillain-Barré syndrome. The Lancet Neurology. 2008 Oct 1;7(10):939-50.
  22. Shahrizaila N, Lehmann HC, Kuwabara S. Guillain-barré syndrome. The lancet. 2021 Mar 27;397(10280):1214-28.
  23. Oomes PG, Jacobs BC, Hazenberg MP, Bänffer JR, van der Meché FG. Anti‐GM1 IgG antibodies and Campylobacter bacteria in Guillain‐Barré syndrome: evidence of molecular mimicry. Annals of neurology. 1995 Aug;38(2):170-5.
  24. Sheikh KA, Nachamkin I, Ho TW, Willison HJ, Veitch J, Ung H, Nicholson M, Li CY, Wu HS, Shen BQ, Cornblath DR. Campylobacter jejuni lipopolysaccharides in Guillain-Barré syndrome: molecular mimicry and host susceptibility. Neurology. 1998 Aug;51(2):371-8.
  25. Visser LH, Van der Meché FG, Meulstee J, Rothbarth P, Jacobs BC, Schmitz PI, Van Doorn PA. Cytomegalovirus infection and Guillain-Barré syndrome: the clinical, electrophysiologic, and prognostic features. Neurology. 1996 Sep;47(3):668-73.
  26. Ilyas AA, Willison HJ, Quarles RH, Jungalwala FB, Cornblath DR, Trapp BD, Griffin DE, Griffin JW, McKhann GM. Serum antibodies to gangliosides in Guillain‐Barré syndrome. Annals of Neurology: Official Journal of the American Neurological Association and the Child Neurology Society. 1988 May;23(5):440-7.
  27. Hafer‐Macko C, Hsieh ST, Ho TW, Sheikh K, Cornblath DR, Li CY, McKhann GM, Asbury AK, Griffin JW. Acute motor axonal neuropathy: an antibody‐mediated attack on axolemma. Annals of Neurology: Official Journal of the American Neurological Association and the Child Neurology Society. 1996 Oct;40(4):635-44.
  28. Griffin JW, Li CY, Macko C, Ho TW, Hsieh ST, Xue P, Wang FA, Cornblath DR, McKhann GM, Asbury AK. Early nodal changes in the acute motor axonal neuropathy pattern of the Guillain-Barré syndrome. Journal of neurocytology. 1996 Jan; 25:33-51.
  29. Chiba A, Kusunoki S, Shimizu T, Kanazawa I. Serum IgG antibody to ganglioside GQ1b is a possible marker of Miller Fisher syndrome. Annals of Neurology: Official Journal of the American Neurological Association and the Child Neurology Society. 1992 Jun;31(6):677-9.
  30. Chiba A, Kusunoki S, Obata H, Machinami R, Kanazawa I. Serum anti‐GQ1b IgG antibody is associated with ophthalmoplegia in Miller Fisher syndrome and Guillain‐Barré syndrome: clinical and immunohistochemical studies. Neurology. 1993 Oct;43(10):1911
  31. Rahman RS, Bauthman MS, Alanazi AM, Alsillah NN, Alanazi ZM, Almuhaysin MI, Almutairi RK, Binobaid KS, Alharthi YH, Bawareth RM, Alrawili ON. Guillain–Barré syndrome: pathophysiology, etiology, causes, and treatment. International Journal of Community Medicine and Public Health. 2021 Jul;8(7):3624.
  32. Yuki, N., Yamada, M., Koga, M., Odaka, M., Susuki, K., Tagawa, Y., Ueda, S., Kasama, T., Ohnishi, A., Hayashi, S. and Takahashi, H., 2001. Animal model of axonal Guillain‐Barré syndrome induced by sensitization with GM1 ganglioside. Annals of Neurology: Official Journal of the American Neurological Association and the Child Neurology Society, 49(6), pp.712-720.
  33. Burns TM. Guillain-barré syndrome. InSeminars in neurology 2008 Apr (Vol. 28, No. 02, pp. 152-167). © Thieme Medical Publishers.
  34. Jacobs BC, Rothbarth PH, Van der Meché FG, Herbrink P, Schmitz PI, De Klerk MA, Van Doorn PA. The spectrum of antecedent infections in Guillain-Barré syndrome: a case-control study. Neurology. 1998 Oct;51(4):1110-5.
  35. Susuki K, Nishimoto Y, Yamada M, Baba M, Ueda S, Hirata K, Yuki N. Acute motor axonal neuropathy rabbit model: immune attack on nerve root axons. Annals of neurology. 2003 Sep;54(3):383-8.
  36. Yuki N, Yamada M, Koga M, Odaka M, Susuki K, Tagawa Y, Ueda S, Kasama T, Ohnishi A, Hayashi S, Takahashi H, Kamijo M, Hirata K. Animal model of axonal Guillain-Barre Syndrome induced by sensitization with GM1 ganglioside. Ann Neurol. 2001 Jun;49(6):712-20.
  37. Chiba A, Kusunoki S, Obata H, Machinami R, Kanazawa I. Serum anti-GQ1b IgG antibody is associated with ophthalmoplegia in Miller Fisher syndrome and Guillain-Barré syndrome: clinical and immunohistochemical studies. Neurology. 1993 Oct;43(10):1911-7 Willison HJ, O'Hanlon G, Paterson G, O'Leary CP, Veitch J, Wilson G, Roberts M, Tang T, Vincent A. Mechanisms of action of anti-GM1 and anti-GQ1b ganglioside antibodies in Guillain-Barré syndrome. J Infect Dis. 1997 Dec;176 Suppl 2: S144-9. 
  38. Chiba A, Kusunoki S, Shimizu T, Kanazawa I. Serum IgG antibody to ganglioside GQ1b is a possible marker of Miller Fisher syndrome. Ann Neurol. 1992 Jun;31(6):677-9.
  39. Cosi V, Versino M. Guillain-barre syndrome. Neurological Sciences. 2006 Mar; 27:47-51.
  40. https://www.ninds.nih.gov/health-information/disorders/guillain-barre-syndrome
  41. https://my.clevelandclinic.org/health/diseases/15838-guillain-barre-syndrome
  42. Newswanger DL, Warren CR. Guillain-Barré syndrome. American family physician. 2004 May 15;69(10):2405-10.
  43. Ropper AH. The Guillain–Barré syndrome. New England journal of medicine. 1992 Apr 23;326(17):1130-6
  44. Asbury AK, Cornblath DR. Assessment of current diagnostic criteria for Guillain‐Barré syndrome. Annals of Neurology: Official Journal of the American Neurological Association and the Child Neurology Society. 1990;27(S1): S21-4.
  45. Gordon PH, Wilbourn AJ. Early electrodiagnostic findings in Guillain-Barré syndrome. Archives of neurology. 2001 Jun 1;58(6):913-7.
  46. Mori M, Kuwabara S, Fukutake T, Yuki N, Hattori T. Clinical features and prognosis of Miller Fisher syndrome. Neurology. 2001 Apr 24;56(8):1104-6.
  47. Rees JH, Soudain SE, Gregson NA, Hughes RA. Campylobacter jejuni infection and Guillain–Barré syndrome. New England Journal of Medicine. 1995 Nov 23;333(21):1374-9.
  48. Lasky T, Terracciano GJ, Magder L, Koski CL, Ballesteros M, Nash D, Clark S, Haber P, Stolley PD, Schonberger LB, Chen RT. The Guillain–Barré syndrome and the 1992–1993 and 1993–1994 influenza vaccines. New England Journal of Medicine. 1998 Dec 17;339(25):1797-802.
  49. Hahn AF. Guillain-barré syndrome. The lancet. 1998 Aug 22;352(9128):635-41.
  50. Lindenbaum Y, Kissel JT, Mendell JR. Treatment approaches for Guillain-Barre Syndrome and chronic inflammatory demyelinating polyradiculoneuropathy. Neurologic clinics. 2001 Feb 1;19(1):187-204.
  51. Sharshar T, Chevret S, Bourdain F, Raphaël JC, French Cooperative Group on Plasma Exchange in Guillain-Barré Syndrome. Early predictors of mechanical ventilation in Guillain-Barré syndrome. Critical care medicine. 2003 Jan 1;31(1):278-83.
  52. Sater RA, Rostami A. Treatment of Guillain-Barre Syndrome with intravenous immunoglobulin. Neurology. 1998 Dec;51(6_suppl_5): S9-15.
  53. Hughes RA, Swan AV, Van Doorn PA. Intravenous immunoglobulin for Guillain‐Barré syndrome. Cochrane Database of Systematic Reviews. 2014(9).
  54. Korinthenberg R, Schessl J, Kirschner J, Mönting JS. Intravenously administered immunoglobulin in the treatment of childhood Guillain-Barré syndrome: a randomized trial. Pediatrics. 2005 Jul 1;116(1):8-14.
  55. French Cooperative Group on Plasma Exchange in Guillain‐Barrk Syndrome. Efficiency of plasma exchange in Guillain‐Barré syndrome: role of replacement fluids. Annals of neurology. 1987 Dec;22(6):753-61.
  56. Guillain-Barré Syndrome Study Group*. Plasmapheresis and acute Guillain‐Barré syndrome. Neurology. 1985 Aug;35(8):1096-.
  57. Bril V, Ilse WK, Pearce R, Dhanani A, Sutton D, Kong K. Pilot trial of immunoglobulin versus plasma exchange in patients with Guillain-Barré syndrome. Neurology. 1996 Jan;46(1):100-3.
  58. McKhann GM, Griffin JW, Cornblath DR, Mellits ED, Fisher RS, Quaskey SA, Guillain‐Barré Syndrome Study Group. Plasmapheresis and Guillain‐Barré syndrome: analysis of prognostic factors and the effect of plasmapheresis. Annals of neurology. 1988 Apr;23(4):347-53.
  59. Thornton CA. Safety of intravenous immunoglobulin. Archives of Neurology. 1993 Feb 1;50(2):135-6.
  60. Mori M, Kuwabara S, Fukutake T, Hattori T. Intravenous immunoglobulin therapy for Miller Fisher syndrome. Neurology. 2007 Apr 3;68(14):1144-6.
  61. McLeod JG. Invited review: autonomic dysfunction in peripheral nerve disease. Muscle & Nerve: Official Journal of the American Association of Electrodiagnostic Medicine. 1992 Jan;15(1):3-13.
  62. Chevret S, Hughes RA, Annane D. Plasma exchange for Guillain‐Barré syndrome. Cochrane Database of Systematic Reviews. 2017(2).

Guillain-Barre Syndrome (GBS) is rare yet serious acute immune-mediated polyneuropathy impacting peripheral nervous system, often occurring after an infection. It usually manifests as rapidly advancing, symmetrical weakness in the limbs, areflexia, and sensory disturbances of varying degrees. GBS encompasses various clinical forms, such as Acute Inflammatory Demyelinating Polyradiculoneuropathy (AIDP), Acute Motor Axonal Neuropathy (AMAN), as well as Miller Fisher Syndrome (MFS). From an epidemiological perspective, the global incidence of GBS is 0.89-1.89 cases per 100,000 person-years, with higher frequency observed among older adults and males. Infections, especially Epstein-Barr virus, cytomegalovirus, Campylobacter jejuni, as well as Zika virus, correlate with regional and seasonal variations. The pathogenesis includes molecular mimicry, where antibodies cross-react with gangliosides on peripheral nerves, leading to demyelination or axonal degeneration. The diagnosis is mainly clinical, corroborated by Nerve conduction studies (NCS), as well as analysis of Cerebrospinal fluid (CSF) that demonstrates albuminocytological dissociation. GBS constitutes a medical emergency because of the dangers of respiratory failure, autonomic dysfunction, and cranial nerve involvement. During the acute phase, supportive care such as respiratory monitoring, Deep-vein thrombosis (DVT) prophylaxis, and nutritional support is essential. During recovery, rehabilitation plays an important part, centring on the restoration of motor function, complication prevention, and enhancement of quality of life. Although the majority of patients recover, a subset continues to experience long-term disability and fatigue. It is essential to identify early, treat promptly, and manage with a multidisciplinary approach in order to achieve optimal outcomes. To enhance patient care and reduce long-term complications, ongoing investigation into immunopathogenesis and treatment approaches is essential.

Keywords : Acute Inflammatory Demyelinating Polyradiculoneuropathy, Acute Motor Axonal Neuropathy, Miller Fisher Syndrome, Nerve Conduction Studies, Deep Vein Thrombosis Prophylaxis.

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