Prognosis

The overall prognosis for patients with Guillain-Barre syndrome (GBS) is good, with approximately 85% of survivors making a good functional recovery. Miller-Fisher syndrome has a better prognosis than other GBS subtypes, and most patients recover completely without treatment within 6 months.[21]

Recovery from severe disease may be prolonged, but most patients regain the ability to walk independently.[190] Up to 80% of patients are able to walk independently 6 months after disease onset, with or without treatment.[21] A majority of severely disabled patients with acute motor axonal neuropathy have been found to walk independently within a few years.[2]

Guidelines on neuroprognostication recommend the Erasmus GBS Respiratory Insufficiency Score (EGRIS) score for predicting the need for mechanical ventilation within 14 days of disease onset in the acute phase, and the Erasmus GBS Outcome Score (EGOS) or modified EGOS (mEGOS) score for predicting the likelihood of independent ambulation at 3 months or later in the recovery phase.[132][133][163]​ These scores are considered moderately reliable predictors and may be useful when counselling patients or their carers on their prognosis, but it is important to emphasise that they provide estimates only and there is considerable uncertainty.[132]

Factors associated with poorer outcome include more severe weakness, rapid onset, older age, muscle wasting, electrically inexcitable nerves, and preceding diarrhoeal illness.[1][39]​​[191]​​

Most patients with a poor outcome have been mechanically ventilated. Mortality of 20% has been demonstrated in these patients.[190]

Acute and long-term disability appear to be associated with axonal involvement and a GBS-disability scale grade ≥2 at the lowest point.[192]

Long-term symptoms reported by patients who have recovered from acute GBS include neuropathic pain, fatigue, and muscle weakness.[21]

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