Subject(s)
COVID-19 , Guillain-Barre Syndrome , Guillain-Barre Syndrome/etiology , Humans , Pandemics , SARS-CoV-2Subject(s)
Guillain-Barre Syndrome/drug therapy , Immunosuppressive Agents/administration & dosage , Mycophenolic Acid/analogs & derivatives , Adult , Aged , Anti-Inflammatory Agents/administration & dosage , Drug Therapy, Combination , Female , Humans , Immunoglobulins, Intravenous/administration & dosage , Male , Methylprednisolone/administration & dosage , Middle Aged , Mycophenolic Acid/administration & dosage , Pilot ProjectsABSTRACT
The occurrence of severe fatigue after Guillain-Barré syndrome (GBS), and its relation with disease course, clinical characteristics, and antecedent infections was studied in 100 GBS patients. Severe fatigue, expressed as a mean Fatigue Severity Scale (FSS) score of 5.0 or more, was present in 60% of all patients. It was more frequently present in females and in patients over 50 years (p < 0.01). There was no significant relationship between fatigue severity and the level of functional disability at nadir, antecedent events or infections, clinical variables, and time to follow-up after GBS.
Subject(s)
Fatigue/etiology , Guillain-Barre Syndrome/complications , Guillain-Barre Syndrome/psychology , Adult , Cross-Sectional Studies , Disability Evaluation , Disease Progression , Female , Follow-Up Studies , Humans , Male , Middle Aged , Prospective Studies , Severity of Illness Index , Time FactorsABSTRACT
OBJECTIVE: Fatigue is a major complaint in patients with immune mediated polyneuropathies. Despite apparently good physical recovery after Guillain-Barré syndrome (GBS), many patients remain restricted in daily and social activities, and have a decreased quality of life. In this trial, the effect of amantadine on severe fatigue related to GBS was studied. METHODS: During the pre-treatment phase, all patients were monitored for 2 weeks. Only patients with severe fatigue, defined as a mean fatigue score of > or = 5.0 on the Fatigue Severity Scale (FSS), were randomised for this double blind, placebo controlled, crossover study. Primary outcome measure was improvement of at least 1 point on the FSS. Secondary outcome measures were impact of fatigue, anxiety and depression, handicap, and quality of life. RESULTS: In total, 80 patients with GBS were randomised, of whom 74 were included for analysis. Fatigue appeared to be reduced already during the pre-treatment phase (p = 0.05), probably due to increased attention provided to the patients. No significant differences in any of the primary and secondary outcome measures were found. CONCLUSIONS: Amantadine was not superior to placebo. Because fatigue remains a serious complaint, other studies evaluating new treatment options are strongly recommended.
Subject(s)
Amantadine/therapeutic use , Antiviral Agents/therapeutic use , Fatigue/drug therapy , Fatigue/etiology , Guillain-Barre Syndrome/psychology , Adult , Aged , Aged, 80 and over , Amantadine/adverse effects , Antiviral Agents/adverse effects , Anxiety/diagnosis , Anxiety/epidemiology , Anxiety/etiology , Cross-Over Studies , Depression/diagnosis , Depression/epidemiology , Depression/etiology , Double-Blind Method , Fatigue/epidemiology , Female , Guillain-Barre Syndrome/complications , Humans , Male , Middle Aged , Quality of Life/psychologyABSTRACT
Many patients with Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyneuropathy (CIDP) experience excessive fatigue, which may persist for years and reduce quality of life. The authors performed a 12-week study of bicycle exercise training in 20 patients with severe fatigue, 16 with relatively good recovery from GBS, and 4 with stable CIDP. Training seemed well tolerated, and self-reported fatigue scores decreased 20% (p = 0.001). Physical fitness, functional outcome, and quality of life were improved.
