Guillain-Barré Syndrome

Kiran Panesar, BPharmS (Hons), MRPharmS, RPh, CPh, MPSK


US Pharmacist. 2014;39(1):35-38. 

In This Article

Abstract and Introduction


Guillain-Barré syndrome is a heterogeneous condition with several variant forms that is the most common cause of acute flaccid paralysis in both children and adults. It is estimated that the condition affects about 1 to 3 individuals per 100,000 persons. Patients typically complain of increasing pain and weakness in the limbs associated with tingling dysesthesias in the extremities. The majority of patients with Guillain-Barré have been diagnosed with an infection in the 3 weeks prior to the development of symptoms. Other events that have been linked to the disorder include vaccinations, surgery, and certain drugs. Therapy includes immunotherapy to accelerate the recovery process as well as specific therapies for individual patients such as pain relief.


Guillain-Barré syndrome (GBS) is a heterogeneous condition associated with immunemediated, reactive, self-limiting peripheral neuropathies.[1,2] It represents at least five different entities that are associated with an increased concentration of cerebrospinal fluid protein but a normal cell count and manifest as systemic motor paralysis.[1,2]

Three of these forms predominantly affect the motor system: acute motor axonal neuropathy (AMAN), acute motor-sensory axonal neuropathy (AMSAN), and acute inflammatory demyelinating polyradiculoneuropathy (AIDP).[1] The other two variants are Miller Fisher syndrome and acute pandysautonomic neuropathy.[1]

GBS is the leading cause of flaccid paralysis in Western countries. It is estimated that direct healthcare costs of patients in the United States alone amount to $110,000 per person, and costs due to a loss in productivity per patient run close to $360,000 annually.[2,3]

The disorder, triggered by a preceding bacterial or viral infection, causes respiratory failure requiring mechanical ventilation in approximately 25% of cases.[2] Mortality rates in patients requiring mechanical ventilation are as high as 20%, with persistent disability and persistent fatigue in 20% and 67% of patients, respectively.[4]