Heterotopic ossification in Guillain-Barré syndrome: incidence and effects on functional outcome with long-term follow-up

Zeilig G, Weingarden HP, Levy R, Peer I, Ohry A, Blumen N. Heterotopic ossification in Guillain-Barre syndrome: incidence and effects on functional outcome with long-term follow-up. Objective To define the incidence, effects on functional abilities, and possible causation of heterotopic ossification (HO) in Guillain-Barre syndrome (GBS) patients admitted for inpatient rehabilitation. Design Long-term prospective study on neurologic and functional outcome of GBS patients admitted for rehabilitation. Setting Rehabilitation department, inpatient and outpatient, within a university-affiliated medical center. Participants All GBS patients admitted for rehabilitation and followed for a minimum of 3 years. Interventions Not applicable. Main Outcome Measures Presence of HO, factors that may be etiologically significant, and effects on functionality. Data included: medical interventions, Disability Grading Scale, need for assisted ventilation, electrodiagnostic findings, autonomic function, standard neuro-musculo-skeletal evaluation, and hospital length of stay. Results Four (6%) of 65 patients had HO, 24 of whom required mechanical ventilation. All had decreased range of motion in the involved hips that affected mobility. Conclusions Even though it has been rarely reported, HO does occur in GBS and affects functional outcome.