A retrospective analysis of outcome in severe Guillain-Barre syndrome following combined neurological and rehabilitation management

Abstract

Purpose: To determine the outcome in severe Guillain-Barre syndrome following combined neurological and rehabilitation management using standardized disability and handicap measures and to identify the factors which affect this outcome.

Methods: A retrospective study was performed of 24 patients with Guillain-Barre Syndrome admitted over a 3 year period to the neurological rehabilitation unit of the National Hospital for Neurology and Neurosurgery. Queen Square, London. Disability and handicap on admission and discharge were measured using the modified Barthel Index (BI), Functional Independence Measure (FIM). Environmental Status Scale (ESS) and Handicap Assessment Scale (HAS). Data was collected to identify any factors affecting outcome; age at onset, time to nadir, duration of ventilation, total in-patient stay, duration of stay at the neurological rehabilitation unit, symptoms, signs and electrophysiological findings.

Results: The majority of patients had multiple problems. Outcome was related to the duration of rehabilitation. The mean modified BI score and the FIM score increased whereas ESS scores and HAS scores decreased, these changes were compatible with a reduction in disability and handicap.

Conclusions: Significant improvement in function occurred during rehabilitation. These changes can be demonstrated using standardized outcome measures.