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Guillain-Barré Syndrome

A rare condition in which the immune system attacks the nerves, causing weakness and tingling that can spread quickly, often from the legs upward. It is treated in hospital, and most people recover — but weakness that is spreading, or any trouble breathing or swallowing, needs emergency care.

Go to the emergency room or call 911 for weakness or tingling that is spreading quickly, any trouble breathing or swallowing, or weakness in both legs that is getting worse over hours or days. The GBS|CIDP Foundation advises calling 911 for sudden, rapid weakness, tingling or paralysis, especially with trouble breathing or swallowing (GBS|CIDP Foundation).

What is Guillain-Barré syndrome?

Guillain-Barré syndrome (said “ghee-YAN bah-RAY”), or GBS, is a rare autoimmune disorder in which the immune system mistakenly attacks the peripheral nerves, which carry signals between the brain and spinal cord and the rest of the body (NINDS). In the most common type the attack damages myelin, the insulating sheath around nerve fibers; in other types the nerve fibers themselves are damaged. GBS is not contagious and is not inherited (NINDS).

Symptoms

GBS begins suddenly. Some cases are mild, with only brief weakness; others lead to near-total paralysis (NINDS). Common signs include:

By the third week, 90% of people are at their weakest (NINDS).

What triggers it?

The exact cause is unknown (NINDS). About two in three people had diarrhea or a respiratory illness before GBS began (CDC).

How common is it?

GBS is rare. CDC estimates that about 3,000 to 6,000 people develop it each year in the United States (CDC, CDC) — about 1 to 2 out of every 100,000 people (CDC). Anyone can get it, but it is more common in men and in people over 50 (CDC).

Variants: Miller Fisher syndrome

Miller Fisher syndrome mainly affects the nerves of the head: the eye muscles become weak or paralyzed, balance and coordination suffer, and reflexes are lost (NINDS). It can overlap with the classic form (ten-step guideline).

How it’s diagnosed

GBS can be hard to diagnose early (NINDS). Doctors look for weakness on both sides of the body, note how fast it came on and check reflexes (NINDS). A recent bout of diarrhea or a respiratory infection makes GBS more likely (EAN/PNS guideline). Tests can include:

Why it’s treated in hospital

GBS can worsen rapidly and is a medical emergency (Merck Manual). People are usually admitted, often to intensive care, so the team can act quickly (NINDS). Three dangers drive this:

Most people recover fully, but some have permanent nerve damage, and some people have died from GBS (CDC) — see Recovery and rehabilitation below.

CIDP: a related, longer-lasting condition

Chronic inflammatory demyelinating polyneuropathy (CIDP) also happens when the immune system attacks the myelin around nerves; it causes weakness and reduced feeling in the arms and legs that build up over time (NINDS). Unlike GBS, which usually peaks and then improves after one episode, CIDP is chronic and may relapse, often needing ongoing treatment (GBS|CIDP Foundation). If weakness keeps getting worse for more than 8 weeks, doctors consider CIDP rather than GBS; about 5% of people first diagnosed with GBS turn out to have it (Merck Manual, EAN/PNS guideline). Separate MBHA guides on Nerve Damage, Paraplegia and Wheelchair Users are on the way.

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) Hospital admission and close monitoring of breathing, heart rate and blood pressure; IVIG or plasma exchange; a ventilator if needed; pain medicines; prevention of blood clots and other complications; then physical and occupational therapy. Physical therapy about $50–$350+ a session without insurance, or a $10–$75 copay with it; Medicare Part B covers needed outpatient therapy (20% after the deductible). Hospital care, IVIG and plasma exchange: cost estimate being researched. IVIG and plasma exchange are equally effective and speed recovery; steroids don’t help. Most people recover, though some keep weakness, numbness, fatigue or pain.
Chiropractic No role in acute GBS. Later in recovery, at most gentle musculoskeletal care with your neurologist’s clearance. Cost estimate being researched. We found no studies of chiropractic care for GBS. GBS can start with back, neck or shoulder pain, so new weakness or tingling needs a doctor first. MBHA advises against forceful manipulation while muscles are weak.
Acupuncture Fine needles, sometimes added to standard hospital treatment for weakness, numbness or pain. Cost estimate being researched. We found little research: one non-randomized 2026 study and case reports. It is not known whether acupuncture helps GBS. Never a substitute for IVIG or plasma exchange.
Herbal medicine No herb or supplement treats GBS. Cost estimate being researched. During the acute illness, take nothing without the hospital team’s agreement. Some herbs interact with medicines, such as blood thinners.
Massage therapy Gentle massage during recovery for muscle aches and stiffness, cleared by your care team. Cost estimate being researched. May ease discomfort, but evidence for GBS is limited to one case report. Keep it gentle; it doesn’t treat the nerve damage.
MBHA Wellness Coach Paced return to activity, fatigue management, home safety and fall prevention, emotional recovery, caregiver support and connection with the GBS|CIDP Foundation. MBHA coaching cost estimate being researched. Supports — never replaces — your medical and rehabilitation team. Fatigue, anxiety and depression are common after GBS and can be helped.

Approach 1 of 6

Conventional medicine (AMA)

There is no cure for GBS, but some treatments reduce its severity and shorten recovery, and the team treats complications as the nerves heal (NINDS). We don’t list doses here.

1. Hospital monitoring

Care usually starts in the hospital, often the intensive care unit, with close tracking of muscle strength, breathing and heart rate (NINDS). Guidelines advise regular checks of breathing, swallowing and coughing, plus heart-rhythm tracing, blood pressure and bowel and bladder function (ten-step guideline).

2. IVIG or plasma exchange

Two treatments interrupt the immune attack, and both are equally effective if started within two weeks of symptoms (NINDS):

The evidence: a 2017 Cochrane review of six trials (649 people) found moderate-quality evidence that plasma exchange gave more improvement than supportive care alone, and that full strength at one year was more likely (Cochrane review, 2017). A 2014 Cochrane review found moderate-quality evidence that, in severe GBS, IVIG started within two weeks speeds recovery as much as plasma exchange, with no more side effects, and that people are much more likely to complete an IVIG course (Cochrane review, 2014). Because IVIG is easier to give and more widely available, it is usually the first choice (ten-step guideline). Both treatments shorten the hospital stay and speed recovery (Merck Manual).

3. Steroids don’t help

A 2016 Cochrane review of six trials (587 people) found that steroids given alone don’t speed recovery or change the long-term outcome, and very low-quality evidence suggested steroid pills may even delay recovery (Cochrane review, 2016). The European guideline recommends against steroid pills for GBS (EAN/PNS guideline).

4. Help with breathing

Because breathing can fail, it is watched closely, and a mechanical ventilator is sometimes used to support it; with careful intensive care, even people whose breathing fails usually survive (NINDS).

5. Pain relief

Pain is common in GBS but often under-recognized (Cochrane review). The European guideline makes a weak recommendation for nerve-pain medicines — gabapentinoids, tricyclic antidepressants or carbamazepine (EAN/PNS guideline). A 2015 Cochrane review found only three short-term trials, with very low-quality evidence that gabapentin and carbamazepine lowered pain, and not enough evidence to support any one medicine (Cochrane review, 2015).

6. Preventing blood clots and other complications

Lying in bed raises the risk of deep vein thrombosis (blood clots in the leg veins), pressure sores and infections, and standard preventive care is recommended (ten-step guideline). Nurses use soft mattresses and turn people with severe weakness regularly (Merck Manual). If swallowing is weak, people may need special care to prevent choking and pneumonia (NINDS).

7. Rehabilitation: physical and occupational therapy

Physical therapy starts early to keep joints flexible and prevent shortened muscles, with the therapist moving the limbs at first and the person moving them as strength returns (Merck Manual). Occupational and vocational therapy teach new ways to manage daily tasks and work and find the right equipment (NINDS). See Recovery and rehabilitation below.

What it costs

  • Physical therapy: about $50–$350 or more a session without insurance; with insurance, typically a $10–$75 copay or 10–50% coinsurance. Therapy in a hospital tends to cost more, and a long course of rehabilitation (for example after a serious accident or major surgery) can total thousands of dollars or more (CostHelper, a consumer cost guide). Medicare Part B covers medically necessary outpatient physical therapy with no yearly limit; you pay 20% of the approved amount after the deductible (Medicare.gov).
  • Hospital and intensive care, IVIG and plasma exchange: cost estimate being researched. The GBS|CIDP Foundation lists financial-assistance resources (GBS|CIDP Foundation).

Find a medical doctor in our directory

Approach 2 of 6

Chiropractic

Chiropractic is a licensed health profession whose treatment usually involves hands-on therapy, often spinal manipulation (NCCIH). It has no role in treating acute GBS, which needs hospital care (CDC). Our PubMed search found no studies of chiropractic care for GBS.

Back, neck or shoulder pain with new weakness or tingling needs a doctor first. GBS can begin with deep pain in the back or legs (NINDS), and published case reports describe GBS first mistaken for a spinal disc problem (case report, PubMed) or for wear-and-tear changes in the neck (case report, PubMed), and starting with neck and shoulder pain (case report, PubMed).

Later in recovery

If you later want help for aches or stiffness, get your neurologist’s clearance first, keep the care gentle, and tell the practitioner you have had GBS. Serious side effects of spinal manipulation are very rare but may be more likely in people with underlying health problems (NCCIH). As an MBHA caution, we advise against forceful manipulation while muscles are still weak; your physical therapist is the main guide to rebuilding strength.

Cost estimate being researched.

Find a chiropractor in our directory

Approach 3 of 6

Acupuncture

We found little research on acupuncture for GBS, and no randomized trials.

  • 2026 observational study: 128 hospital patients with GBS were followed for two weeks; the 58 who also had acupuncture were more likely to improve on strength and disability scores (observational study, PubMed). Patients were grouped by the treatment they received rather than randomly assigned, so the study can show a link but not that acupuncture caused the improvement.
  • A 2022 case report describes a man whose numbness and fatigue eased after four acupuncture sessions following IVIG; the authors say more robust evidence is needed (case report, PubMed).

In short: it is not known whether acupuncture helps GBS. If you want to try it, use it only alongside — never instead of — hospital treatment, and ask your neurologist first.

Safety

Cost estimate being researched.

Find an acupuncturist in our directory

Approach 4 of 6

Herbal medicine

No herb or supplement has been shown to treat GBS. Apart from IVIG and plasma exchange, no other treatment has been proven to work (ten-step guideline).

During the acute illness, take no supplements unless the hospital team agrees. Supplements can interact with medicines and pose risks with some medical problems, so tell your providers about everything you take (NCCIH). People with weak swallowing also need special care to prevent choking (NINDS), so nothing should be taken by mouth without the team’s say-so.

Interactions to know about

We don’t list doses here. Ask your doctor or pharmacist before trying any supplement. Cost estimate being researched.

Approach 5 of 6

Massage therapy

During recovery, gentle massage may ease muscle aches and stiffness, but we found little research on massage for GBS. A 2001 single-patient case report described aromatherapy massage used alongside nursing care for joint pain and constipation in intensive care (case report, PubMed); one case can’t show massage works. Heat therapy may make physical therapy more comfortable (Merck Manual).

Safety

The risk of harm from massage appears low, but rare serious problems — including a blood clot, nerve injury or bone fracture — have been reported, some with vigorous deep-tissue massage (NCCIH). Because long periods in bed raise the risk of deep vein thrombosis (ten-step guideline), check with your care team before any massage and keep it gentle. Cost estimate being researched.

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

Recovery from GBS can take weeks to years (NINDS). An MBHA Wellness Coach can help you turn your rehabilitation team’s advice into daily habits — always alongside medical care, never instead of it.

A paced return to activity

Exercise programs that include range-of-motion work, cycling, walking and strength training can improve fitness, walking and independence, but intensity must be watched because overdoing it can cause fatigue (ten-step guideline). A coach can help you stick to your therapist’s plan and build in rest.

Managing fatigue

Fatigue is one of the most common lasting problems after GBS. A 2025 review of 12 studies found it in about a third of people in the recovery phase (meta-analysis, PubMed). Other causes of tiredness should be checked first, and a graded, supervised exercise program has helped reduce fatigue (ten-step guideline); in a small 2022 trial, supervised exercise beat a home program (randomized trial, PubMed). Our Chronic Fatigue guide covers a different condition, ME/CFS, but its tips on planning energy may be useful.

Home safety and fall prevention

GBS can leave weakness, numbness and unsteadiness (NINDS). Remove things you could trip over, add grab bars in the bathroom and railings on both sides of stairs, and improve lighting (CDC). Occupational therapists can recommend assistive devices (NINDS). See our Balance guide.

Emotional recovery

Sudden paralysis and depending on others can be extremely hard, and some people need counseling (NINDS). A 2025 review of 19 studies found that many people have symptoms after GBS that may meet the criteria for anxiety or depression, and that these are likely underdiagnosed and undertreated (systematic review, PubMed). In a Danish study, about 1 in 5 people were diagnosed with depression or started an antidepressant within two years of GBS, with the risk highest in the first three months (cohort study, PubMed). Support groups can ease the emotional strain (NINDS). See our Anxiety and Depression guides. If you have thoughts of suicide, call or text 988; it is free, confidential and available 24/7 (988 Lifeline).

Support for caregivers

The GBS|CIDP Foundation encourages care partners to ask for and accept help before burnout, look after their own sleep and meals, and use respite and support groups; it notes that anger, fear and depression are normal reactions to a sudden illness (GBS|CIDP Foundation). People with GBS, even when fully paralyzed, usually remain fully conscious and can see and hear, so be mindful of what is said at the bedside and explain what is happening (ten-step guideline).

Connect with others

The GBS|CIDP Foundation International (gbs-cidp.org, 866-224-3301) offers information and support (NINDS, GBS|CIDP Foundation), including a community forum, a health navigator and links to specialist centers (GBS|CIDP Foundation). Meeting people who have had GBS can help guide recovery (ten-step guideline). MBHA coaching cost estimate being researched.

Another approach

Recovery and rehabilitation

Most people with GBS, even those who were fully paralyzed or needed a ventilator for a long time, recover a great deal, especially in the first year; about 80% can walk on their own six months after onset (ten-step guideline). Most people start to recover 2 to 3 weeks after symptoms begin, and recovery can take a few weeks or a few years (CDC). Without treatment most people improve slowly over months; with early treatment, improvement can come in days or weeks (Merck Manual).

Another approach

GBS and vaccines: what the evidence shows

Most cases of GBS are not linked to vaccines (CDC). Here is what CDC reports:

  • 1976 swine flu vaccine: a slightly increased risk of about one additional case for every 100,000 people vaccinated (CDC).
  • Seasonal flu vaccines: the link varies from season to season; when there has been an increased risk, it has been about 1 to 2 additional cases per million doses (CDC, CDC). Studies suggest a person is more likely to get GBS after having the flu than after a flu vaccine (CDC).
  • Other vaccines: on very rare occasions, GBS has developed in the days or weeks after certain vaccines, such as Shingrix and the Janssen COVID-19 vaccine; associations for other vaccines are being assessed (CDC). CDC found an increased risk after the J&J/Janssen COVID-19 vaccine in adults, but not after the Pfizer-BioNTech or Moderna vaccines (CDC).

CDC and FDA closely monitor vaccine safety (CDC), and CDC says the benefits of vaccination far outweigh the risks (CDC).

If you have had GBS: a past episode is not a strict reason to avoid vaccines. Experts suggest discussing it if your GBS was less than a year ago or followed the same vaccine, weighing the benefit against a small and possibly only theoretical risk (ten-step guideline). Talk with your doctor. See our Flu guide.

Member stories

Living with Guillain-Barré Syndrome? Share your experience

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Sources

This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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