Guillain-Barre Syndrome, Clinical Features at Presentation and Outcome

Abstract

Objective: To evaluate the frequency of clinical features of Guillain-Barre Syndrome at presentation and outcome of disease.
Methods: All patients who presented to accident and emergency department of Akhtar Saeed Trust Hospital Lahore and Farooq hospital Lahore; and were diagnosed to have Guillain-Barre Syndrome (using Brighton criteria for the diagnosis of Guillain-Barre syndrome)1 were included in the study. Atotal of 64 patients of Guillain-Barre Syndrome over a period of 3 years were studies. There were 37 male and 27 were female patients.
Results: Patients of adult age group with the age range from 15-73 were included in the study; and the highest incidence was in the age group 55-65 (57%). Regarding the antecedent infection, 40.6% had history of diarrhea and 26.56% had suffered from upper respiratory tract infection in the previous two to four weeks. As regards neurological features, 87.5% had acute flaccid
paralysis, 53.12% had cranial nerves involvement, 73.43% had sensory deficits and 62.5% suffered from pain. Regarding autonomic dysfunction, out of 64 patients, 45.31% had tachycardia, 4.68% had bradycardia, 43.7% had paroxysmal hypertension, 17.18% had
orthostatic hypotension, 17.18% had urinary bladder dysfunction, and 21.87% had diarrhea/constipation. Electromyography (EMG) was performed on all 64 patients, 3.12% had normal EMG, 43.75% were shown to have demyelinating neuropathy, 21.87% had axonal
neuropathy and the results were equivocal in 31.25%. Out of 64 patients, 20.31% needed mechanical ventilation on admission and 25% needed mechanical ventilation during their stay in the hospital. After a follow up of 06 moths, 76.56% could walk independently, 15.62% patients had some disability due to their GBS and walked with some aids, while 7.81% died during their stay in the hospital.
Conclusions: Guillain-Barre Syndrome patients need careful monitoring for respiratory, autonomic and cardiovascular complications and may need ICU management in about 1/3rdof cases.
Keywords: guillain-barre syndrome.