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Guillain-Barré Syndrome
Guillain-Barré Syndrome (GBS) is a rare autoimmune condition where the body’s immune system attacks the nerves. This leads to rapidly progressive weakness, numbness and, in some cases, temporary paralysis.
Symptoms usually start in the legs and move upwards, and can develop over days to a few weeks. Many people require hospital care, and some need intensive care for breathing support. Recovery can be slow and incomplete without specialist rehabilitation.
At The Royal Buckinghamshire Hospital, we provide inpatient neurorehabilitation for adults recovering from GBS, including those with complex physical, respiratory and functional needs after acute treatment.
Causes and triggers
GBS often develops after:
- A viral or bacterial infection (for example, respiratory or gastric illness)
- Less commonly, surgery or other immune triggers
The exact cause is not fully understood, but the immune system mistakenly attacks the peripheral nerves, interrupting the signals between the brain and muscles.
Symptoms of Guillain-Barré Syndrome
Symptoms can vary, but common features include:
Early symptoms
- Tingling or “pins and needles” in the feet and hands
- Weakness starting in the legs and moving upwards
- Difficulty climbing stairs, standing from a chair or walking
Progressive weakness
- Increasing weakness in legs, arms and sometimes facial muscles
- Difficulty lifting arms, gripping objects or holding cutlery
- Reduced or absent reflexes
- Problems with balance and coordination
Sensory and autonomic symptoms
- Numbness, burning or altered sensations
- Pain in the back, limbs or muscles
- Changes in blood pressure or heart rate
- Problems with bladder or bowel in some cases
Breathing and swallowing
In more severe GBS, the muscles used for breathing and swallowing can be affected:
- Shortness of breath or difficulty taking a deep breath
- Weak cough
- Swallowing difficulties, with risk of choking or chest infections
These symptoms are managed in the acute hospital, often in a high-dependency or intensive care unit.
Diagnosis and acute treatment
GBS is usually diagnosed and treated in an acute hospital. The diagnostic process may include:
- Clinical assessment of pattern and speed of weakness
- Nerve conduction studies and electromyography (EMG)
- Lumbar puncture (spinal tap)
- Blood tests and other investigations to rule out alternative causes
Acute treatments aim to stop or reduce the immune attack, for example:
- Intravenous immunoglobulin (IVIG)
- Plasma exchange (plasmapheresis)
These treatments do not immediately reverse the damage but can help shorten the course and limit severity. Rehabilitation then supports recovery over the following weeks and months.
Recovery after Guillain-Barré Syndrome
Most people with GBS improve over time, but recovery can be slow and variable. Some are left with ongoing weakness, fatigue, pain or sensory changes. Common issues during recovery include:
- Weakness and reduced stamina
- Problems with walking, balance and transfers
- Difficulty with everyday activities such as washing, dressing and eating
- Persistent pain and altered sensations
- Fatigue, anxiety and low mood
Specialist neurorehabilitation can help people regain independence, manage symptoms and adapt to any long-term changes.
Neurorehabilitation at The Royal Buckinghamshire Hospital
The Royal Buckinghamshire Hospital provides specialist inpatient neurorehabilitation for adults recovering from GBS, including those with complex needs following intensive care or prolonged hospital stays.
Multidisciplinary team (MDT)
Your rehabilitation programme may involve:
- Consultants in Rehabilitation Medicine and Neurology
- Specialist rehabilitation doctors and nurses
- Physiotherapists
- Occupational therapists
- Speech and language therapists
- Neuropsychologists and clinical psychologists
- Dietitians and pharmacists
- Respiratory therapists where needed
- Social workers and discharge planners
We work with you and your family to set goals, review progress and plan for a safe discharge.
Rehabilitation focus areas
Physiotherapy
Physiotherapy aims to restore strength, mobility and function while avoiding over-fatigue:
- Individualised strengthening and conditioning programmes
- Gradual standing and walking practice, including use of hoists, standing frames or body-weight support if needed
- Balance and gait re-education
- Advice on pacing, rest and safe progression of activity
- Prescription of walking aids and orthoses
Occupational therapy
Occupational therapists focus on independence in daily activities:
- Assessment of personal care (washing, dressing, toileting)
- Practising everyday tasks with adaptive techniques and equipment
- Assessment for wheelchairs and seating, including pressure care
- Recommendations for home adaptations (grab rails, ramps, bathroom equipment)
- Energy conservation, fatigue management and planning daily routines
Speech and language therapy
Where GBS has affected swallowing or communication, speech and language therapists may provide:
- Swallowing assessments and strategies to reduce choking and aspiration risk
- Advice on food and fluid textures and safe eating positions
- Communication strategies if facial or bulbar muscles are involved
Psychological, cognitive and family support
- Assessment and support for mood, anxiety and adjustment
- Strategies to cope with fatigue, pain and sleep disturbance
- Education for families and carers about GBS and its recovery pattern
- Support with goal setting and planning for return to work or other roles where appropriate
Nutrition and medical management
- Dietetic support to maintain nutrition and hydration, especially after prolonged illness
- Ongoing medical management of pain, spasticity, autonomic symptoms and other complications
- Respiratory monitoring and support where necessary
Complications we aim to prevent or manage
Following GBS, especially after prolonged hospital or ICU stays, people may be at risk of:
- Contractures and joint stiffness
- Pressure ulcers and skin breakdown
- Recurrent chest infections
- Deep vein thrombosis (DVT) and deconditioning
- Persistent pain and neuropathic pain
- Severe fatigue and reduced exercise tolerance
- Reduced confidence and fear of activity
Our rehabilitation programmes are designed to minimise these risks and support a sustainable level of independence and activity.
Who may benefit from admission?
Inpatient GBS rehabilitation at The Royal Buckinghamshire Hospital may be suitable for adults who:
- Are in the recovery phase after Guillain-Barré Syndrome
- Have ongoing weakness, mobility or balance problems
- Need help to regain independence in daily activities
- Have complex medical, respiratory or equipment needs
- Require coordinated multidisciplinary rehabilitation after an ICU or prolonged hospital stay
We accept referrals from acute hospitals, neurologists, rehabilitation consultants, GPs, case managers, solicitors and insurers.
Referrals and further information
To discuss a potential referral for Guillain-Barré Syndrome rehabilitation or to learn more about our services:
- Visit our Neurological Rehabilitation and Inpatient Rehabilitation pages
- Contact our referrals team by telephone or secure email
Our aim is to help each person recovering from GBS – and those who support them – to maximise recovery, independence and quality of life.
4 December 2025