[The Landry-Guillain-Barré syndrome. Study of prognostic factors in 223 cases].

A retrospective study of 223 patients (111 men, 112 women, mean age 40.6 years) with the Landry-Guillain-Barre syndrome investigated vital or functional prognostic factors. Patients were first seen between 1963 and 1981, when 192 were noted to have cranial nerve disorders. Assisted ventilation was required in 152 cases, and 23 patients died, including 5 from cardiocirculatory dysautonomy. Plasma exchange was not used. Patients were divided into 3 groups as a function of the degree of maximum paralysis: group 1 (n = 63) patients had incomplete quadriplegia without assisted ventilation, group 2 (n = 93) incomplete quadriplegia with assisted ventilation, group 3 (n = 62) quadriplegia with or without assisted ventilation. Vital prognosis was related to the severity of neurologic disorders. Frequency of intercurrent complications, dysautonomic disorders and mortality increased with maximal severity of motor deficit. The 3 groups did not differ as a function of previous history, mode of onset of polyradiculoneuritis, duration of extension phase of paralysis, or CSF protein content at the first examination during the extension phase of the paralyses. It is therefore impossible at an early stage of the disease to predict future motor deficit. The cumulative percentage of patients who recovered a normal muscular force in limbs and cranial territories was 48 p. 100 after one year and 60 p. 100 after two years (actuarial values). The functional prognosis depends upon the degree of motor deficit at maximum paralysis and duration of the plateau phase. Probability of full muscular strength recovery was lower in group 3 and in those patients with a plateau phase duration longer than 2 weeks. Independently of groups, motility recovery rate was markedly higher in patients with a plateau phase duration of less than one week. Motility recuperation was independent of age, sex, duration of extension phase, CSF protein levels during the acute phase, and presence of autonomic nervous system disorders.