Symptoms of Guillain-Barre can get worse very quickly. It may take only a few hours to reach the most severe symptoms, but weakness increasing over several days is also common.

Muscle weakness or the loss of muscle function (paralysis) affects both sides of the body. In most cases, the muscle weakness starts in the legs and then spreads to the arms. This is called ascending paralysis.

Patients may notice tingling, foot or hand pain, and clumsiness. If the inflammation affects the nerves to the diaphragm, and there is weakness in those muscles, the person may need breathing assistance.

Typical symptoms include:

• Loss of reflexes in the arms and legs
• Muscle weakness or loss of muscle function (paralysis)
  • In mild cases, there may be no weakness or paralysis
  • May begin in the arms and legs at the same time
  • May get worse over 24 to 72 hours
  • May occur in the nerves of the head only
  • May start in the arms and move downward
  • May start in the feet and legs and move up to the arms and head
• Numbness, decreased sensation
• Sensation changes
• Tenderness or muscle pain (may be a cramp-like pain)
• Uncoordinated movement

Additional symptoms may include:

• Blurred vision
• Clumsiness and falling
• Difficulty moving face muscles
• Muscle contractions
• Palpitations (sensation of feeling heartbeat)

Emergency symptoms (seek immediate medical help):

• Breathing temporarily stops
• Can't take a deep breath
• Difficulty breathing
• Difficulty swallowing
• Drooling
• Fainting
• Feeling light-headed when standing

A history of increasing muscle weakness and paralysis may be a sign of Guillain-Barre syndrome, especially if there was a recent illness.

A medical exam may show muscle weakness and problems with involuntary (autonomic) body functions such as blood pressure and heart rate. The examination may also show that reflexes, such as the "knee jerk," are decreased or missing.

There may be signs of decreased breathing (caused by paralysis of the breathing muscles).

The following tests may be ordered:

• Cerebrospinal fluid sample ("spinal tap") may have increased levels of protein without an increase in white blood cells.
• ECG may show heart problems in some cases.
• EMG tests the electrical activity in muscles. It may show that nerves do not react properly to stimulation.
• Nerve conduction velocity test shows that electrical activity along the nerves is slowed or blocked.