Diagnosing certain diseases is straightforward, but Guillain-Barré Syndrome (GBS) is not one of them. This rare nerve disorder can appear suddenly, often after an infection & progress quickly. It leads to muscle weakness, paralysis & breathing difficulties, making early detection essential. However, doctors face several challenges in identifying GBS on time, which can delay treatment & increase risks for the patient. Here’s why identifying GBS on time is not always easy & why delays can be risky.

Why GBS is hard to identify
1. Symptoms can be misleading – Weakness and tingling in the legs can be confused with other problems like a stroke, nerve damage, or muscle diseases.

2. No single test gives a clear answer – There is no one test that can immediately confirm GBS. Doctors have to check symptoms, medical history & test results together.

3. Spinal Fluid (CSF) test may not show immediate signs – The CSF test is one of the main tests for GBS, but in the first few days, the fluid may look normal. In fact, only half of GBS patients show a high protein level in the first week. After seven days, this number rises to 80%. This means testing too early can give unclear results, which may lead to a late diagnosis.

4. Nerve tests might not work in the beginning – A nerve conduction test can help confirm GBS, but in the early days of the illness, results may not be clear.

5. GBS looks like other diseases – GBS can seem like conditions such as spinal cord injuries, botulism, or myasthenia gravis. Without proper tests, doctors might think the patient has a different illness.

Risks of late diagnosis
GBS gets worse quickly, and most patients reach their weakest point within two weeks. If doctors don’t diagnose it in time, treatment is delayed, which can lead to:
• Permanent nerve damage
• Severe breathing problems, with 1 in 5 patients needing a ventilator.
• Death in 5% of cases, even with medical care.

In places where hospitals don’t have the right testing facilities, the chances of late diagnosis & complications increase.

How to make GBS diagnosis easier
1. Repeat CSF tests if needed – If the first spinal fluid test looks normal but doctors still think it could be GBS, they should test again after 2–3 days.

2. Use nerve tests early – Even though nerve studies may not always show clear results in the beginning, they should still be done as soon as possible.

3. Train doctors to recognize GBS – Since GBS can be confused with other illnesses, doctors need to know the signs & when to suspect it.

4. Improve access to tests– More hospitals, especially in smaller towns & villages, need better testing facilities to avoid delays.

GBS is a serious medical problem & every minute matters. Since diagnosing it is difficult, doctors need to use multiple tests & observe the patient. By raising awareness, improving access to testing & making quicker decisions, GBS can be found earlier, helping patients get the right treatment on time.

Dr. Sameer Bhati, Director of Star Imaging and Path Lab Pvt. Ltd