title: Prevalence of fatigue in Guillain-Barre syndrome in neurological rehabilitation setting.
abstract: BACKGROUND
  Fatigue contributes significantly to the morbidity and affects the quality of life adversely in Guillain-Barre Syndrome (GBS).
  
  
  OBJECTIVE
  To determine the prevalence of fatigue in GBS in neurological rehabilitation setting and to study its clinical correlates.
  
  
  METHODS
  We performed secondary analysis of data of patients with GBS admitted in neurological rehabilitation ward of a tertiary care centre, recorded at both admission and discharge. Assessment of fatigue was done by Fatigue Severity Scale (FSS), disability-status by Hughe's Disability Scale (HDS), functional-status by Barthel Index, anxiety/depression by Hospital Anxiety Depression Scale, sleep disturbances by Pittsburgh Sleep Quality Index and muscle weakness by Medical Research Council sum scores.
  
  
  RESULTS
  A total of 90 patients (62 men) with mean age 34 years (95% CI 32.2, 37.7) were included. Median duration of, stay at neurological rehabilitation ward was 30 days, while that of symptoms was 18.5 days. Presence of fatigue at admission (FSS ≥ 4 in 39% patients) was associated with ventilator requirement (P = 0.021) and neuropathic pain (P = 0.03). Presence of fatigue at discharge (FSS ≥ 4 in 12% patients) was associated with disability- HDS (≥3) (P = 0.008), presence of anxiety (P = 0.042) and duration of stay at rehabilitation ward (P = 0.02). Fatigue did not correlate with age, gender, antecedent illness, muscle weakness, depression and sleep disturbances.
  
  
  CONCLUSIONS
  Fatigue is prevalent in GBS during early recovery phase of illness. Despite motor recovery fatigue may persist. Knowledge about fatigue as burden of disease in these patients will improve patient care.
authors.affiliation: Department of Neurological Rehabilitation, National Institute of Mental Health and Neurosciences, Bangalore, India.
authors.forename: Prajna
authors.initials: P
authors.lastname: Ranjani
authors.affiliation: Department of Neurological Rehabilitation, National Institute of Mental Health and Neurosciences, Bangalore, India.
authors.forename: Meeka
authors.initials: M
authors.lastname: Khanna
authors.affiliation: Department of Neurological Rehabilitation, National Institute of Mental Health and Neurosciences, Bangalore, India.
authors.forename: Anupam
authors.initials: A
authors.lastname: Gupta
authors.affiliation: Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India.
authors.forename: Madhu
authors.initials: M
authors.lastname: Nagappa
authors.affiliation: Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India.
authors.forename: Arun B
authors.initials: AB
authors.lastname: Taly
authors.affiliation: Department of Medical Epidemiologist (Independent), Bangalore, Karnataka, India.
authors.forename: Partha
authors.initials: P
authors.lastname: Haldar
keywords: Fatigue; Guillain Barre syndrome; rehabilitation