Complications and Risk Stratification
Pain in GBS can be severe and resistant to treatment.
Autonomic failure occurs in up to two-thirds of patients, and can lead to cardiac arrhythmias and blood pressure fluctuations. This can occasionally be associated with sudden death.
Fatigue is a common and long-lasting complication.
Risk stratification
A largely arbitrary distinction is made between ‘mild’ and ‘severe’ GBS on the basis of whether the patient is able to walk.
The more severe the weakness, the worse the prognosis, and if respiratory muscles are affected then ICU treatment may be required.
Increasing age and a history of preceding diarrhoea are other factors indicating a poorer prognosis.
GBS is a progressive disease and all patients, whatever the severity, should be referred for in-patient specialist assessment and treatment.
Warning: Any patient in whom GBS is suspected must be admitted as progression of the disease can be rapid.