Guillain-Barré syndrome natural history, complications, and prognosis: Difference between revisions
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==Prognosis== | ==Prognosis== | ||
* [[Recovery]] can take weeks or years. | * [[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. | * 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. | * 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. | |||
==Possible complications== | ==Possible complications== | ||
Revision as of 03:05, 27 February 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Priyamvada Singh, MBBS [2]
Overview
Guillain-Barré syndrome (GBS) is an acute, autoimmune, polyradiculoneuropathy affecting the peripheral nervous system, usually triggered by an acute infectious process. 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
- 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).
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.
Possible complications
- Breathing difficulty (respiratory failure) due to involvement of respiratory system.
- Low or unstable blood pressure (due to autonomic system involvement)
- Paralysis or paresis (Permanent loss of movement of an area)
Complications caused due to immobility
- Contractures of joints or other deformity
- Deep vein thrombosis (blood clots
- Increased risk of infections
- Sucking food or fluids into the lungs (aspiration)
- Pneumonia