Long term disability and social status change after Guillain-Barré syndrome.
OBJECTIVE
Even if the majority of patients with Guillain-Barré syndrome (GBS) have a favourable functional outcome some residual motor and sensory signs and symptoms may remain. The aim of this study was to evaluate the long-term effect of GBS on daily life,working activities, hobbies and social status and the presence of residual symptoms.


METHODS
Seventy patients with GBS enrolled in a case-control study were examined. Information on signs or symptoms during the acute phase of the disease was retrieved from medical records and an ad-hoc questionnaire administered during hospitalization. Patients were interviewed by phone 3 to 5 years after disease onset about residual symptoms and changes in daily living. Disability and handicap were assessed using the Hughes, Rankin and Rotterdam 9-items scale.


RESULTS
At follow-up 45 patients (64 %) made a complete functional recovery; 19 patients (27%) had some minor limitations in daily life although they were able to perform all their activities independently while 6 (9 %) needed aid for some hours or continuously during the day. Nineteen patients (27 %) had, however, to make substantial changes in their job, hobbies or social activities. There was no significant correlation between clinical and laboratory features during the acute phase of GBS and outcome.


CONCLUSIONS
Although over 90% of our GBS patients had a more or less complete functional recovery, almost 30% of them had to make substantial changes in daily life. These findings indicate that GBS still has a significant impact on patients' life which may go beyond their residual disability or impairment. Treatment of GBS should not be only aimed at improving patients' disability but also at limiting the impact of the disease on their social life.
Bersano
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Giorgio Spagnol Service of Clinical Neuroimmunology, Department of Neurological Sciences, Dino Ferrari Center, Milan University, IRCCS Ospedale Maggiore Policlinico, Italy.
Carpo
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Allaria
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Franciotta
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D
Citterio
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Nobile-Orazio
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D020275:Guillain-Barre Syndrome / Q000401:mortality / Q000503:physiopathology* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012922:Social Change