In those who have received intravenous immunoglobulins, a smaller increase in IgG in the blood two weeks after administration is associated with poorer mobility outcomes at six months than those whose IgG level increased substantially. If the disease continues to progress beyond four weeks, or there are multiple fluctuations in the severity (more than two in eight weeks), the diagnosis may be chronic inflammatory demyelinating polyneuropathy, which is treated differently.In research studies, the outcome from an episode of Guillain–Barré syndrome is recorded on a scale from 0 to 6, where 0 denotes completely healthy; 1 very minor symptoms but able to run; 2 able to walk but not to run; 3 requiring a stick or other support; 4 confined to bed or chair; 5 requiring long-term respiratory support; 6 death.The health-related quality of life (HRQL) after an attack of Guillain–Barré syndrome can be significantly impaired. About a fifth are unable to walk unaided after six months, and many experience chronic pain, fatigue and difficulty with work, education, hobbies and social activities. HRQL improves significantly in the first year. Epidemiology
In Western countries, the number of new episodes per year has been estimated to be between 0.89 and 1.89 cases per 100,000 people. Children and young adults are less likely to be affected than the elderly: the relative risk increases by 20% for every decade of life. Men are more likely to develop Guillain–Barré syndrome than women; the relative risk for men is 1.78 compared to women.The distribution of subtypes varies between countries.
Whereas the hysterias involved at their source a narrowing of the field of consciousness, the psychasthenias involved at root a disturbance in the fonction du reél (function of reality), a kind of weakness in the ability to attend to, adjust to, and synthesise ones changing experience (cf. executive functions in todays empiricist psychologies). Carl Gustav Jung later made the hysteric and the psychasthenic states the prototypes of what he described as extroverted and introverted personalities.Karl Jaspers preserves the term "neurasthenia", defining it in terms of "irritable weakness" and describing phenomena such as irritability, sensitivity, a painful sensibility, abnormal responsiveness to stimuli, bodily pains, strong experience of fatigue, etc. This is contrasted with "psychasthenia", which, following Janet, he describes as a variety of phenomena "held together by the theoretical concept of a diminution of psychic energy." The psychasthenic person prefers to "withdraw from his fellows and not be exposed to situations in which his abnormally strong complexes rob him of presence of mind, memory and poise." The psychasthenic lacks confidence, is prone to obsessional thoughts, unfounded fears, self-scrutiny and indecision. This state in turn promotes withdrawal from the world and daydreaming, yet this only makes things worse. "The psyche generally lacks an ability to integrate its life or to work through and manage its various experiences; it fails to build up its personality and make any steady development." Jaspers believed that some of Janets more extreme cases of psychasthenia were cases of schizophrenia. References


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