Guillain-Barré Syndrome, or GBS for short, is a rare but potentially serious condition that can occur after an infection. 

GBS is caused by the body’s immune system attacking the peripheral nervous system – this is made up of nerves that branch out from the spinal cord and allow you to move, feel sensations and control bodily functions such as breathing and urinating.

GBS symptoms can range from mild to severe and include:

• Double vision

• Speech and swallowing problems

• Muscle weakness resulting in paralysis

• Incoordination / unsteadiness

• Numbness (reduced or altered sensation, including pain)

• Severe breathing difficulties requiring intensive care

Symptoms develop rapidly, often after a prior infection, and generally begin to reverse six weeks after they start. 

While many patients make a good recovery and go back to their ‘normal’ lives, some can have slower recovery and suffer from long term residual functional impairment including immobility and difficulties with self-care.

What are the early signs of GBS? What are the risk factors? Can it be prevented? If you have these questions or more, submit them now – but hurry, this Q&A is only for a limited time!

About Dr Christen Lim

Dr Christen Lim graduated from Yong Loo Lin School of Medicine, National University of Singapore, in 2014 and he qualified as a neurologist in 2021. 

His interest in Guillain-Barre Syndrome was sparked after seeing a patient with GBS while he was a medical student, and he has since been actively conducting research to improve understanding and diagnosis of the condition.

Questions and answers on Guillain-Barré Syndrome (GBS)

1. Question by Phyllis

Dear Dr,

I have weak legs (both legs) but able to walk normally. Do I have GBS?

Answer by Dr Christen Lim

Dear Phyllis, I would advise you to seek medical attention to properly evaluate your condition.

Weakness of the legs can arise from a wide variety of conditions, of which GBS is one of the possibilities. S

ome features that we look for when diagnosing patients with GBS include (but are not limited to) the development of rapid onset of weakness and numbness (developing/progressing within hours to days), involvement of the upper and/or lower limbs, blurring of vision, and speech and swallowing problems.

2. Question by Shahid

Dear Dr Lim,

May I know if there's a check-up for this? Is it covered by Medisave? Thanks!

Answer by Dr Christen Lim

Dear Shahid, GBS is a condition with a fairly rapid onset of symptoms (limb weakness/numbness, blurring of vision, speech and swallowing problems, to name a few); this develops over a matter of hours to days. 

If you or your loved ones are experiencing such symptoms, I would advise for you to seek an early/urgent review at the Emergency Department. Depending on the outcome of the doctors’ evaluation, you will be recommend a plan that may include hospital admission for investigation and treatment. 

Specific details regarding MediSave coverage will depend on your disposition (admission or follow-up in clinic) and investigations/treatments planned.

3. Question by Chan

Hi Dr Lim,

If one had prior stroke, does it predispose one to GBS?

Answer by Dr Christen Lim

Dear Chan, GBS is an inflammation of the peripheral nerves in the body resulting from an abnormal immune system response. This abnormal immune response typically arises following an infection. 

Stroke is not a predisposing factor for the development of GBS.

4. Question by Richard

Dear Dr Lim,

Few questions I would want to enquire:

a) Is GBS also closely associated or link to Myasthenia gravis? I am a myasethnia gravis patient

b) One of the symptoms is muscles numbness on leg, at one stage I encountered muscle numbness on left thighs couple with severe allergies on the skin.. It has since subsided but the thigh feel sensation is no longer the same as my normal right thigh.

I have seek medical treatment and they told me potentially could be shingles due to symptoms.. I only received some applied cream to relieve the itch as they could not prescribed medicine due to my medication for myasethnia gravis (predisolone, cellcept and mestinon). Thank you.

Answer by Dr Christen Lim

Dear Richard, thank you for the questions.

a) Although both GBS and myasthenia gravis (MG) involve abnormalities in the immune system response that result in damage to neurological structures (peripheral nerves in GBS, and neuromuscular junctions in MG), the underlying processes driving these diseases are different. There is no close linkage between the two conditions.

b) I am sorry to hear that you developed what sounds like shingles. Shingles arises from a reactivation of a previously dormant varicella zoster virus infection (which initially causes chickenpox), and this is a completely different process from GBS. Do reach out to your doctor to discuss strategies to manage your symptoms.

5. Question by Vincent

Dear Dr Christen Lim,

I was glad to learn more about GBS on HealthXchange.

Recently, I have experienced the following symptoms:

• Binocular double vision

• Numbness in the big toe of my left foot, occurring at bedtime

How can I determine whether these symptoms are caused by Guillain-Barré Syndrome (GBS)? Thank you.

Answer by Dr Christen Lim

Dear Vincent, thank you for the question. 

As a clarification, the term “binocular double vision” means that you are experiencing double vision when both eyes are open but have normal vision when one eye is closed and the other open. This results from the inability to align the eyes to focus on a visual target, due to weakness of the muscles controlling eye movements.

GBS is a condition with a fairly rapid onset of symptoms (limb weakness/numbness, blurring of vision, speech and swallowing problems, to name a few); this develops over a matter of hours to days. 

Should you have concerns of having GBS, do seek medical attention for proper evaluation.

6. Question by Sunderason

Hello Dr,

I have been diagnosed with GBS in 2013, and now the diagnosis has changed to Cryoglubulinaemia related vasculitis mononeuritis multiplex.

I have the tingling and the burning sensation with pins and needles on all my limps.

I'm prescribed with cellcept 1000 mg a day. But my pins and needles, burning sensation and tingling feelings have not subsided yet.

If you could advise, it would be greatly appreciated. Thank you.

Answer by Dr Christen Lim

Dear Sunderason, thank you for your sharing and I’m sorry to hear you are still experiencing symptoms.

The experience you shared raises an important point. GBS is one of the diagnoses we consider when a person first develops a peripheral nerve condition of fairly rapidly onset.

However, a key feature of GBS is that it stabilises after approximately 6 weeks — this is not the case for many other inflammatory nerve conditions, including vasculitic neuropathy (which you were subsequently diagnosed with). 

The treatment goals for vasculitic neuropathy would include control of the nerve inflammation (drugs such as cellcept achieve this), and management of symptoms. Do speak with your doctor regarding treatment options.

7. Question by Ang KH

Dear Dr Christen Lim,

I have consulted a specialist for double vision. Both of my eyes already go through cataract surgery and left eye seeing near sight with big image, right eye for far sight so that I can do my outdoor activities without wearing spectacles.

I have a spectacles suppose to do the vertical prism correction for my double issue but it is not really work. This is because from the first look I got a clear single vision but it will slowly go away after 5 secs approx.

According to the Dr, it is due to the neuro issue from my brain but not serious enough for any surgery at the moment.

I would be highly appreciative it if you are able to offer any advice or treatment for this case. Thank you.

Answer by Dr Christen Lim

Dear Ang KH, thank you for the sharing. 

Unfortunately the issue you describe will require more detailed evaluation than what can be provided in this Q&A section. I would encourage you to discuss your condition further with your doctor regarding further evaluation and management.

8. Question by Lau BH

Dear Dr Christen Lim,

I have been having both feet tired after exercise for about 1 hours. This has been happened for a year. Another issue is also standing too long waiting for transport or queuing for payment my right side back feels painful.

I would like to ask, what is my problems and what advice for treatment. I am a retiree and 75 years old. Thank you.

Answer by Dr Christen Lim

Dear Lau, thank you for reaching out. 

GBS is an inflammatory condition affecting the nerves in the body, arising from an abnormal immune system response, typically to a prior infection. The condition typically stabilises after approximately 6 weeks following onset, and gradually improves thereafter over time.

Your condition being present for a year, and pain in the back from standing too long suggests a separate condition – I would advise for you to seek formal medical attention to evaluate your condition and to obtain medical advice specific for your complaints.

9. Question by Hwee Ho

Hi Dr Christen Lim,

I would like to ask you does Parkinson Disease also similar to GBS as I have a brother who had Parkinson disease and cannot swallow and finally passed on.

Hope you can enlighten on this issue. I myself also have Parkinson disease but is minor. My hands tremors. Thank you.

Answer by Dr Christen Lim

Dear Hwee Ho, sorry to hear about your brother. 

Swallowing difficulties can be caused by a large variety of conditions, including diseases like Parkinson’s Disease and GBS. However, I would like to point out that these two diseases are very different conditions.

Parkinson’s disease is a degenerative condition affecting the brain, particularly areas of the brain that control the fluidity of movement. This degenerative condition is expected to progress over time, i.e. if there is swallowing difficulty, this can become worse over time. It is typically associated with slowed movements and limb stiffness, rather than limb weakness and numbness

GBS, on the other hand, results from an abnormal immune system repsonse causing inflammation of the peripheral nerves in the body. Neurological impairments like weakness, numbness and swallowing problems are expected to stabilise within 6 weeks from onset and thereafter recover gradually.

Ref: G25