Outcome and its predictors in Guillain–Barré syndrome
- 1Neuromuscular Clinic, Department of Neurology, University Hospitals of Leicester, Leicester, UK
- 2Department of Neuroscience and Imaging, University “G. d'Annuzio”, Chieti-Pescara, Italy
- Correspondence to Dr Yusuf A Rajabally, Neuromuscular Clinic, Department of Neurology, University Hospitals of Leicester, Leicester General Hospital, Leicester LE5 4PW, UK;
Contributors Both authors contributed to the literature review, analysis of data, writing of first draft and of the final version submitted.
- Received 30 November 2011
- Revised 30 March 2012
- Accepted 4 April 2012
- Published Online First 7 May 2012
Despite the use of plasma exchanges and intravenous immunoglobulins, Guillain-Barré syndrome (GBS) still carries non-negligible morbidity and mortality. Furthermore, the psychosocial consequences of GBS may persist longer than expected. Various aetiological, clinical, electrophysiological and immunological factors may carry prognostic predictive value. The objective of this article was to perform a summary of the current knowledge-base on outcome and its determinants in adequately-treated adult-onset GBS. Relevant prospective literature was reviewed through a Medline search of English-language articles published between 1966 and March 2012. GBS causes severe persistent disability in 14% of patients at 1 year. Loss of full strength, persistent pain and need for professional change occurs in about 40%. Mortality is of about 4% within the first year. Analysis of prognostic predictors consistently demonstrates the negative impact of higher age, preceding diarrhoea, greater disability/weaker muscles at admission, short interval between symptom-onset and admission, mechanical ventilation and absent/low amplitude compound muscle action potentials. Further outcome studies will soon be underway and may in future contribute to adequately integrate all potential factors in more reliable predictive models.
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.