A review of the management of Guillain-Barré syndrome in a regional neurological rehabilitation unit.

A database search was performed to identify all patients presenting to a Rehabilitation Centre over a five-year period with a confirmed diagnosis of Guillain-Barré syndrome. Retrospective analysis of acute and rehabilitation hospital notes was performed and information on demographics, management and outcome obtained. There were equal numbers of males and females with an average age of 36 years. 75% had a prodromal illness and 62.5% presented with distal paraesthesia. 75% exhibited cranial nerve signs and 62.5% required artificial ventilation for a prolonged period. The investigations performed and treatment given varied and did not always coincide with current evidence. An aetiological agent was identified in 50%. There were a wide variety of complications in the acute hospital and the inpatient stay was prolonged in all but 1. There was one complication after transfer to the rehabilitation unit and statistical analysis of the admission and discharge FIM scores revealed a statistically significant improvement in outcome (p = 0.013). There is currently no consensus on the management of patients with GBS in the acute setting despite a wide evidence base. Many patients are being discharged without access to rehabilitation services. Our results suggest that rehabilitation makes a measurable and significant difference and should be available to all patients with GBS.