Prognostic factors in Guillain-Barre' syndrome

Prospective prognostic evaluation of various clinical and investigative parameters in 24 patients of Guillain-Barre' syndrome revealed poor prognosis in patients having rapid onset of illness, severe degree of paralysis and muscle wasting, prolonged period of peak paralysis lasting for more than 2 weeks and delayed onset of recovery not commencing within 3 weeks from the onset of weakness. Bulbar paralysis and respiratory involvement adversely affected the outcome. Electrodiagnostic evidence of fibrillation, polyphasic action potentials and markedly reduced amplitude of motor action potentials were indicative of poor prognosis. However, age and sex of the patients, severity of sensory loss, sphincteric disturbances, CSF findings and nerve conduction velocities did not significantly affect the outcome. Autonomic dysfunctions were noticed in 66.6% cases but were mostly mild and transient, and did not affect the long-term results.