Guillain-Barré syndrome natural history, complications, and prognosis: Difference between revisions
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===Complications=== | ===Complications=== | ||
* Common complications of GBS include: | * Common complications of GBS include:<ref name="pmid15668421">{{cite journal |vauthors=Dornonville de la Cour C, Jakobsen J |title=Residual neuropathy in long-term population-based follow-up of Guillain-Barré syndrome |journal=Neurology |volume=64 |issue=2 |pages=246–53 |date=January 2005 |pmid=15668421 |doi=10.1212/01.WNL.0000149521.65474.83 |url=}}</ref><ref name="pmid9344309">{{cite journal |vauthors=Meythaler JM |title=Rehabilitation of Guillain-Barré syndrome |journal=Arch Phys Med Rehabil |volume=78 |issue=8 |pages=872–9 |date=August 1997 |pmid=9344309 |doi= |url=}}</ref> | ||
** [[respiratory failure]] | ** [[respiratory failure]] | ||
** Autonomic failure | ** Autonomic failure |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Priyamvada Singh, MBBS [2]
Overview
Approximately 80% of patients have a complete recovery within a few months to a year, although minor findings may persist. A patient's outcome is most likely to be very good when the symptoms go away within 3 weeks after they first started. Complications like paralysis, respiratory failure and hypotension can be seen in these patients.
Natural History, Complications, and Prognosis
Natural history
- Most of the time recovery starts after 4th week from the onset of the disease.
- Approximately 80% of patients have a complete recovery within a few months to a year, although minor findings may persist, such as areflexia.
- About 5-10% recover with severe disability, with most of such cases involving severe proximal motor and sensory axonal damage with inability of axonal regeneration.
- However, this is a grave disease and despite all improvements in treatment and supportive care, the death rate among patients with this disease is still about 2-3% even in the best intensive care units.
- Worldwide, the death rate runs slightly higher (4%), mostly from a lack of availability of life support equipment during the lengthy plateau lasting 4 to 6 weeks, and in some cases up to 1 year, when a ventilator is needed in the worse cases.
- About 5-10% of patients have one or more late relapses, in which case they are then classified as having chronic inflammatory demyelinating polyneuropathy (CIDP).
Complications
- Common complications of GBS include:[1][2]
- respiratory failure
- Autonomic failure
- Bulbar pulsy
- Deep vein thrombosis
- Cardiac arrhythmia
- Pain
- Urinary retention
- Ileus
- Persistent fatigue
Prognosis
- Recovery can take weeks or years.
- Approximately 80% of patients have a complete recovery within a few months to a year, although minor findings may persist, such as areflexia.
- About 5–10% recover with severe disability, with most of such cases involving severe proximal motor and sensory axonal damage with inability of axonal regeneration.
- A patient's outcome is most likely to be very good when the symptoms go away within 3 weeks after they first started.
- According to the National Institute of Neurological Disorders and Stroke, about 30% of patients still have some weakness after 3 years. Mild weakness may persist for some people.
- Despite all improvements in treatment and supportive care, the death rate is still about 2–3% even in the best intensive care units.
- Worldwide, the death rate runs slightly higher (4%), mostly from a lack of availability of life support equipment during the lengthy plateau lasting four to six weeks, and in some cases up to one year, when a ventilator is needed in the worst cases.
- About 5–10% of patients have one or more late relapses, in which case they are then classified as having chronic inflammatory demyelinating polyneuropathy (CIDP).
- Poor prognostic factors include age over 40 years, history of preceding diarrheal illness, requiring ventilator support, high anti-GM1 titre, and poor upper limb muscle strength.
References
- ↑ Dornonville de la Cour C, Jakobsen J (January 2005). "Residual neuropathy in long-term population-based follow-up of Guillain-Barré syndrome". Neurology. 64 (2): 246–53. doi:10.1212/01.WNL.0000149521.65474.83. PMID 15668421.
- ↑ Meythaler JM (August 1997). "Rehabilitation of Guillain-Barré syndrome". Arch Phys Med Rehabil. 78 (8): 872–9. PMID 9344309.