Guillain-Barré syndrome natural history, complications, and prognosis: Difference between revisions
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{{Guillain-Barré syndrome}} | {{Guillain-Barré syndrome}} | ||
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==Overview== | ==Overview== | ||
Revision as of 19:29, 14 December 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Fahimeh Shojaei, M.D.
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
- About 65% of patients with GBS will fully recover with no permanent disability.
- 35% of them do not fully recover. 8% of this group will die from GBS complication and others will have permanent disabilities.
- Treatment of GBS just reduce the recovery time and doesn’t affect prognosis.
- Overally, older patients will have worst prognosis in comparison to children who discover very fast.
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.