MEDICAL REHABILITATION IN GUILLAIN-BARRÉ SYNDROME

Abstract

Guillain-Barré Syndrome (GBS) is an acute autoimmune polyneuropathy characterized by progressive muscle weakness and areflexia. This case report details the rehabilitation journey of a 36-year-old male diagnosed with the acute motor-sensory axonal neuropathy (AMSAN) subtype of GBS, complicated by pneumonia, diabetes mellitus type 2, and acute kidney injury. The patient presented with ascending paralysis, respiratory distress, and sensory deficits, requiring intensive care. Electrophysiological studies confirmed AMSAN, showing absent motor and sensory nerve action potentials. Rehabilitation focused on preventing immobilization complications, restoring muscle strength, and improving functional independence. Interventions included gradual mobilization, respiratory exercises (diaphragmatic breathing, active cycle of breathing techniques), neuromuscular electrical stimulation (NMES), sensory re-education, and balance training. By the 15-week follow-up, the patient achieved significant recovery: muscle strength (MRC score improved from 12/60 to 56/60), independent ambulation (10 meters unassisted), and enhanced activities of daily living (Barthel Index increased from 5 to 19). Fatigue and psychological distress also improved, as evidenced by reduced Fatigue Severity Scale (52 to 33) and Hospital Anxiety and Depression Scale scores (borderline to normal).

This case highlights the importance of early, multidisciplinary rehabilitation in GBS, particularly for axonal subtypes, to optimize recovery and quality of life. Tailored interventions addressing respiratory, motor, and psychosocial challenges were critical in achieving functional independence.