Brain, Vol. 119, No. 6, 2053-2061, 1996
© 1996 Guarantors of Brain
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The prognosis and main prognostic indicators of Guillain-Barré syndrome A multicentre prospective study of 297 patients
Correspondence to:
Correspondence to: Dr Ettore Beghi, Istituto di Ricerche Farmacologiche ‘Mario Negri’, Via Eritrea, 62–20157-Milano, Italy
To assess the prognosis of the Guillain-Barré syndrome and identify the main prognostic indicators, 297 patients with Guillain-Barré syndrome recruited through a network of Italian centres were followed up for 24 months or until clinical recovery, whichever was earliest. For each patient the time to plateau, improvement, clinical recovery, or death was calculated, and prognostic indicators (age, sex, antecedent events, disability at admission and nadir, electrophysiological patterns) and treatments were noted. The mean duration of follow-up was 309 days. During this period, 212 patients (71%) recovered, 48 (16%) had residua and 33 (11%) died. The mean times to nadir, improvement and clinical recovery were 12, 28 and 200 days. Using life-tables and survival curves, the cumulative probability of achieving the plateau of symptoms was 73% by 1 week and 98% by 4 weeks. Improvement started during the first week in 36% of cases and within 4 weeks in 85%. The rates of clinical recovery at 1 and 4 weeks, 6, 12 and 24 months were 4, 24, 57, 70 and 82%, respectively. The chance of recovery was significantly affected by age, antecedent gastroenteritis, disability, electrophysiological signs of axonopathy, latency to nadir and duration of active disease. The main treatments did not seem to affect the chance of recovery.
Guillain-Barré syndrome; acute polyneuritis; prognosis; prognostic factor
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Received March 28, 1996. Revised June 1, 1996. Accepted June 24, 1996.
*Principal Investigators: E Beghi, A. Bono and G. Bogliun, Umtà di Malattic Neurologiche, Isliluto di Ricerche Farmacologiche ‘Mano Negri’, Milano; Clinica Neurologica, Ospedale ‘San Gerardo’, Monza. and Ospedale ‘O.S.S.’. IRCCS, San Giovanni Rotondo Steering committee.F. Cornelio, Divisione delle Malaltie Neuromuscolari, Islilulo Neurologico, ‘C. Btsla’, Milano, N Rizzuto, Clinica Neurologica, Ospedale ‘Borgo Roma’, Verona; P. Tonali, Islilulo di Neurologia, Universita Callolica, Policlinico ‘A. Gemeili’, Roma and Ospedale ‘O.S.S.’. IRCCS, San Giovanni Rotondo. Members: D. Zerbi and C. Castelli, Div. di Neurologia, Ospedale ‘S. Carlo’. Milano; G. Ferrari, Ospedale Borgo Trento, Veronà M. Marconi, Cenlro Trasfusionale e lmmunologia dei Trapianli, Policlinico, Milano; P. Simone, F. Apollo, L. Amoniso, P. Crociani and M. Zarrelli, Div. Neurologia. Ospedale ‘Casa Sollievo delta Sofferenza’, IRCCS. San Giovanni Rotondo; C. Angehni and C. Briani, Clinica Neurologica, Universita di Padova; E. Fincati, Clinica Neurologica, Policlinico Borgo, Roma, Verona; R. Affuso, Clinica Neurologica I, Policlinico, Ban; E. Bottacchi, C. Lia and L. Carenini, U.O. di Neurologia, Ospedale Regionale, Aosta; A. M. Veratti, G. Guastella and U. CanistriL, Servizio Trasfusionale, Ospedale di Catanzaro; P. Meineri and E. Grasso, Div. di Neurologia, Ospedale ‘S. Croce’, Cuneo; G. Bargagli and M. Gresli, Servizio di Immunoemalologia, Enle Ospedaliero, Grosselo; G. Cavaletti, P. Santoro and L Marzorau, Clinica Neurologica, Ospedale ‘S. Gerardo’, Monza; C. Antozzi, Islilulo Neurologico ‘C Besta’, Milano; A. Bellini, Istituto di Stat'isiica Medica e Biometria, Universila degli Sludi, Milano; M. Gentilini, C. Lunazzi and P. Sorgato, Clinica Neurologica, Ospedale di Modena; A. M. Fasanar and V. Pizza, Div. di Neurologia, Ospedale ‘Cardarelli’, Napoli; M. T. Mignogna, M. Sabatelli and G. Lippi, Istituto di Neurologia, Universila Caitolica, Policlinico ‘A. Gemeili’, Roma; A. Gomitoni, Div. di Neurologia, Ospedale di Saronno; M. G. Lovaste, Div. di Neurologia, Ospedale di Trento; Gruppo Emiliano-Romagnolo per le problemaliche climco-epidemiologiche in neurologia.
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