Recovery patterns and long term prognosis for axonal Guillain-Barré syndrome.
BACKGROUND
Little is known about the long term prognosis for patients the severe acute motor axonal neuropathy (AMAN) form of Guillain-Barré syndrome (GBS), unlike those with acute inflammatory demyelinating neuropathy (AIDP).


OBJECTIVE
To clarify the long term prognosis for patients with AMAN.


METHODS
Clinical recovery and outcome in 97 consecutive GBS patients were reviewed.


RESULTS
Electrodiagnostic criteria showed that 44 patients (45%) had AMAN, 33 (34%) had AIDP, and 20 (21%) were unclassified. Most of the severely affected patients had received plasmapheresis or immunoglobulin therapy. Slow recovery (inability to walk independently at six months after onset) was found in six of the AMAN patients (14%) and in two of the AIDP patients (6%). Of the six AMAN patients, four could walk independently one year after the onset, and the other two could walk independently at 28 and 57 months after onset. Of the two AIDP patients, one could walk at nine months after the onset while the other died of pneumonia seven months after onset.


CONCLUSIONS
AMAN electrodiagnosis is not always a marker of poor recovery. Almost all the severe AMAN patients who had slow recoveries over the first six months could eventually walk independently, although some required several years.
Hiraga
A
A
Department of Neurology, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba 260-8670, Japan. hiragaa@mail3.alpha-net.ne.jp
Mori
M
M
Ogawara
K
K
Kojima
S
S
Kanesaka
T
T
Misawa
S
S
Hattori
T
T
Kuwabara
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D001369:Axons / Q000473:pathology*; D003711:Demyelinating Diseases / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology; D020275:Guillain-Barre Syndrome / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D020127:Recovery of Function; D012720:Severity of Illness Index
D016756:Immunoglobulins, Intravenous