Guillain-Barré syndrome clinical characteristics and outcomes among U.S. active component service members, 2014-2022

An examination of Guillain-Barré Syndrome (GBS) cases among U.S. active component service members from 2014 through 2022 revealed an incidence rate of 1.6 cases per 100,000 person-years. Individuals younger than age 20 years and those in basic training exhibited higher incidence. The type of antecedent event, either illness or immunization, was not associated with higher disability ratings at long-term follow-up. The analysis also quantified morbidity among service members with GBS, finding that 28.0% of cases had a subsequent chronic pain diagnosis, and 28.7% of cases were referred to the medical evaluation board. The need for neuropathic pain medication during the acute phase predicted poorer long-term functional outcomes. Furthermore, electrodiagnostic evidence of axonal or mixed nerve damage correlated with greater disability after 1 year. Although basic trainees had higher incidence, their long-term morbidity was comparable to other groups. These findings underscore the considerable impact that GBS can have on affected military personnel and identify factors associated with long-term complications. There were 1.6 cases of Guillain-Barré syndrome per 100,000 person years among active component U.S. service members from 2014 through 2022. There was no association between persistent disability and associated antecedent event (e.g., infection or immunization). Many patients experienced incomplete recovery, with 28.7% resulting in medical board referrals. Persistent disability was independently associated with chronic pain diagnosis.