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

Purpose: To determine the outcome in severe Guillain-Barre syndrome followi ng combined neurological and rehabilitation management using standardized d isability and handicap measures and to identify the factors which affect th is outcome. Methods: A retrospective study was performed of 24 patients with Guillain-B arre Syndrome admitted over a 3 year period to the neurological rehabilitat ion unit of the National Hospital for Neurology and Neurosurgery, Queen Squ are, London. Disability and handicap on admission and discharge were measur ed 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 o f stay at the neurological rehabilitation unit, symptoms, signs and electro physiological findings. Results: The majority of patients had multiple problems. Outcome was relate d 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 rehabilita tion. These changes can be demonstrated using standardized outcome measures .