Prognostic Factors for Recovery of Walking in Guillain-Barre syndrome

ABSTRACT

BACKGROUND: Guillain-Barre syndrome (GBS) is an acute autoimmune demyelinating inflammatory polyneuropathy from which most patients ultimately recover satisfactorily. However, up to 22% of patients remain disabled and there is a mortality rate of 3-5%. Identification of prognostic factors for the recovery of walking in GBS is important in counsel-ing individual patients and for earlier therapeutic interventions. Therefore, we analyzed the case-records of patients with GBS to determine features that might be of value in determining outcomes. METHODS: Patients with GBS were recruit-ed according to the GBS diagnostic inclusion and exclusion criteria from 1985 to 1999. The factors including age, interval from onset to maximal disability, degree of maximal functional disability at onset, presence and duration of artificial ventilation, presence of autonomic dysfunction, cranial nerve dysfunction, leukocytosis, and elevated CSF pro-tein, were analyzed to evaluate the determinant indicators for independent walking. RESULTS: Forty-four cases out of 83 GBS patients were selected. The mean duration of recovery to independent walking was 239 days. The severe maximal functional disability at onset, the order age, the shorter interval from onset to maximal disability and the presence of autonomic dysfunction were found to be significant factors on poor outcome. CONCLUSIONS: The degree of maximal functional disability is the most determining factor for the recovery of walking in GBS. The older age at onset and the shorter time-interval from onset to maximal disability and the presence of autonomic dysfunction indicate poor prog-nostic factors in the recovery of walking in GBS.