Neuromuscular effects and rehabilitation in Guillain-Barré syndrome

Abstract

Abstract Guillain-Barre syndrome (GBS) is a postinfectious autoimmune disease of the peripheral nerves most commonly with a severalfold increase in incidence during the 2015–16 Zika virus outbreaks. The severity of GBS can range from mild impairment with fast recovery to complete paralysis including severe respiratory or autonomic failure. Recovery may take months to years and may be incomplete despite disease-modifying treatment with IVIG or plasma exchange. Therefore optimal supportive care and effective rehabilitation remain crucial. Multidisciplinary rehabilitation is recommended but in the acute phase may be challenging because of limited patient participation due to profound weakness and severe pain. Inactive denervated muscles will inevitably undergo rapid degeneration, resulting in wasting, weakness, and contractures as major long-term complications of severely affected patients. In this chapter the current evidence of rehabilitation on the short- and long-term motor function in GBS is reviewed, including newly obtained experience with neuromuscular electrical stimulation. Rehabilitation remains an area lacking well-designed and controlled clinical studies causing a clear lack of evidence-based guidelines.