The overall prognosis for patients with GBS is good, with approximately 85% of survivors making a good functional recovery. Miller-Fisher syndrome has a better prognosis than other GBS subtypes, and most patients recover completely without treatment within 6 months.[11]Leonhard SE, Mandarakas MR, Gondim FAA, et al. Diagnosis and management of Guillain-Barré syndrome in ten steps. Nat Rev Neurol. 2019 Nov;15(11):671-83.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6821638
http://www.ncbi.nlm.nih.gov/pubmed/31541214?tool=bestpractice.com
Recovery from severe disease may be prolonged, but most patients regain the ability to walk independently.[178]Fletcher DD, Lawn ND, Wolter TD, et al. Long-term outcome in patients with GBS requiring mechanical ventilation. Neurology. 2000 Jun 27;54(12):2311-5.
http://www.ncbi.nlm.nih.gov/pubmed/10881259?tool=bestpractice.com
Up to 80% of patients are able to walk independently 6 months after disease onset, with or without treatment.[11]Leonhard SE, Mandarakas MR, Gondim FAA, et al. Diagnosis and management of Guillain-Barré syndrome in ten steps. Nat Rev Neurol. 2019 Nov;15(11):671-83.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6821638
http://www.ncbi.nlm.nih.gov/pubmed/31541214?tool=bestpractice.com
A majority of severely disabled patients with acute motor axonal neuropathy have been found to walk independently within a few years.[2]Hiraga A, Mori M, Ogawara K, et al. Recovery patterns and long term prognosis for axonal Guillain-Barré syndrome. J Neurol Neurosurg Psychiatry. 2005 May;76(5):719-22.
https://jnnp.bmj.com/content/76/5/719.long
http://www.ncbi.nlm.nih.gov/pubmed/15834034?tool=bestpractice.com
Factors associated with poorer outcome include more severe weakness, rapid onset, older age, muscle wasting, electrically inexcitable nerves, and preceding diarrhoeal illness.[1]Hadden RD, Hughes RA. Management of inflammatory neuropathies. J Neurol Neurosurg Psychiatry. 2003 Jun;74(suppl 2):ii9-14.
https://jnnp.bmj.com/content/74/suppl_2/ii9.long
http://www.ncbi.nlm.nih.gov/pubmed/12754323?tool=bestpractice.com
[179]Hadden RD, Karch H, Hartung HP, et al. Preceding infections, immune factors, and outcome in Guillain-Barré syndrome. Neurology. 2001;56:758-765.
http://www.ncbi.nlm.nih.gov/pubmed/11274311?tool=bestpractice.com
[69]Guillain-Barré Syndrome Study Group. Guillain-Barré syndrome: an Italian multicentre case-control study. Neurol Sci. 2000 Aug;21(4):229-34.
http://www.ncbi.nlm.nih.gov/pubmed/11214662?tool=bestpractice.com
Most patients with a poor outcome have been mechanically ventilated. Mortality of 20% has been demonstrated in these patients.[178]Fletcher DD, Lawn ND, Wolter TD, et al. Long-term outcome in patients with GBS requiring mechanical ventilation. Neurology. 2000 Jun 27;54(12):2311-5.
http://www.ncbi.nlm.nih.gov/pubmed/10881259?tool=bestpractice.com
Acute and long-term disability appear to be associated with axonal involvement and a Hughes score ≥2 at the lowest point.[180]Chiò A, Cocito D, Leone M, et al; Piemonte and Valle d'Aosta Register for Guillain-Barré Syndrome. Guillain-Barré Syndrome: a prospective, population-based incidence and outcome survey. Neurology. 2003 Apr 8;60(7):1146-50.
http://www.ncbi.nlm.nih.gov/pubmed/12682322?tool=bestpractice.com
Long-term symptoms reported by patients who have recovered from acute GBS include neuropathic pain, fatigue, and muscle weakness.[11]Leonhard SE, Mandarakas MR, Gondim FAA, et al. Diagnosis and management of Guillain-Barré syndrome in ten steps. Nat Rev Neurol. 2019 Nov;15(11):671-83.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6821638
http://www.ncbi.nlm.nih.gov/pubmed/31541214?tool=bestpractice.com