Heterotopic ossification in Guillain-Barré 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-Barré 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.