Guillain-Barré Syndrome

Plain-language definition

Acute autoimmune neuropathy causing ascending paralysis. Good recovery with intensive rehabilitation.

Signs and points requiring attention

• Progressive ascending motor paralysis: begins in feet, rises to legs, trunk and arms over days to weeks. Involvement can be mild or very severe (complete tetraplegia with respiratory involvement).
• Associated sensory disorders: paresthesias (tingling), sometimes intense neuropathic pain, deep sensory disorders (proprioception). These disorders often precede or accompany paralysis.
• Risk of respiratory involvement from respiratory muscle paralysis: need for close monitoring in intensive care during acute phase. 20-30% of patients require temporary assisted ventilation.
• Intense and lasting fatigue during recovery phase: physical but also mental fatigue, unrelated to effort expended. This fatigue can persist for months after apparent recovery and significantly impact quality of life.

• Breathing difficulties or new breathlessness: even after acute phase, report immediately. May require reevaluation and care adaptation.
• Re-worsening of symptoms after period of improvement: may signal relapse (5% of cases) or CIDP (chronic form). Urgent neurological consultation.
• Severe uncontrolled neuropathic pain: common in Guillain-Barré syndrome, can be disabling. Specific medication available, pain center consultation if necessary.

Assessment and care

• Acute phase: prevention of immobility complications (pressure sores, thrombosis, contractures), gentle passive mobilizations, positioning, respiratory physiotherapy if respiratory muscles affected.
• Recovery phase: progressive motor rehabilitation following recovery pattern (muscles affected last recover first), active work as soon as possible, without excessive fatigue.
• Muscle strengthening adapted to muscle fragility: progressive intensity, many repetitions at low load, avoiding exhaustion which can slow recovery. Dosing is crucial.
• Gait and balance rehabilitation: progressive verticalization, parallel bar work, walking with assistive devices then progressive weaning, proprioceptive work.

This information does not replace diagnosis or medical consultation.