Brief Answer:
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Detailed Answer:
I read your questions carefully and I appreciate your concern about your friend.

Unfortunately, there is not a clear cut answer to your questions. There is not any given time it depends on the patient. The severity of Guillain Barre syndrome varies, some patients may have simply some numbness of the hands and feet never needing a ventilator, some end up needing respiratory support like your friend.

Now how long he will be on ventilator and feeding tube will depend upon his condition. Guillain Barre itself may leave permanent deficits. In addition to that infections and muscle wasting in patients in intensive care units are common. All those may make it extremely difficult for him to breathe or swallow so the doctors are forced to keep the tubes for him to survive. It depends on the patient's condition, if he can only move his head it seems like muscle weakness is too severe for now. Hopefully, over the next months, there will be some improvement, but there is no guarantee.

While in the early stages (first couple of weeks) treatment with immunoglobulins and/or plasmapheresis is tried to limit the damage, by now there is not any specific treatment apart from supportive therapy hoping that there will be some regeneration of the damaged nerves in time.

It is not a question of a drug which can be added or of a specialist who can contribute something extra or make an exact prediction, I am sorry. I can't say how the service is at the current hospital, pressure sores can happen in immobile patients, even at the best clinics. Perhaps you are right and they might've done something more to prevent it, that I can't say, but if you seek to move him in another clinic should do it with extreme cautions.

If you really want to ask for the second opinion, the best clinics in Florida would be the Mayo Clinic in XXXXXXX or the UF Health Shands Hospital in XXXXXXX In XXXXXXX the Baptist hospital is the highest ranked.

I remain at your disposal for other questions.

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Brief Answer:
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Detailed Answer:
Hello again.

In general for Guillain Barre syndrome it worsens during the first weeks reaching a plateau after 2-4 weeks. Afterwards recovery begins which lasts for 6-12 months. Recovery is not always complete. About 10% of patients are left with permanent weakness. Naturally the worse the peak the higher the likelihood for permanent weakness. So since he has had a very severe form, being able to move only his head and needing a ventilator I am afraid potential for permanent disability is higher.

Furthermore there are the dangers which apply to any immobile patient under ventilator (whether with Guillain Barre or not). Dangers which include respiratory infections, urinary infections, sepsis, bed sores, deep vein thrombosis and pulmonary embolism etc, which all influence recovery. The longer it goes the higher the risk of complications.
The muscle weakness for Guillain Barre patients makes it even more difficult to be weaned off the ventilator, takes longer. Furthermore in ICU patients there may be additional damage to the muscles and nerves, so called critical weakness neuropathy and myopathy which slow down improvement.

So what I am trying to say by this long list of possible events is that there is not a predictable timeline, recovery takes 6-12 months, but especially when severity is such to be put under a ventilator there are many other potential factors at play. All that can be done is to try and prevent (at least lower the risk of) those complications from occurring, hoping that over the course of the next 6-12 months nerve and muscle regeneration (when nerves do not send signals muscles undergo atrophy as well) will be enough to allow independent breathing and feeding.

Let me know if I can further assist you.

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