CLINICAL PROFILE AND OUTCOMES OF GUILLAIN-BARRÉ SYNDROME AT A TERTIARY CARE CENTRE IN SOUTHERN INDIA

Anto Ignat Stany M, Susan Dsouza, Peter George

Abstract


Introduction: Guillain-Barré syndrome (GBS) is a demyelinating polyneuropathy characterized by progressive symmetric motor weakness with
reduced or absent deep tendon reflexes. Clinical features, CSF analysis and electro-diagnostic studies aids in diagnosis.
Methods: This study included patients with GBS admitted to a tertiary care center in South India for 3 years from June 2013. Data pertaining to
history, examination and laboratory reports were obtained from medical records and captured into a pre-formatted data sheet and was analysed
using SPSS v20.0.
Results: Among the 48 patients (31 males, 17 females) included in this study, 31% had no antecedent illness, while 30% had history of a nonspecific
febrile illness prior to onset of symptoms. The mean duration between the antecedent event and onset of weakness was 6.75 days. Areflexia
and quadriparesis were the most common clinical features. The incidence of cranial nerve involvement was highly variable, facial nerve being the
commonest. Ten patients progressed to develop respiratory paresis and needed mechanical ventilation. Acute inflammatory demyelinating
polyneuropathy (AIDP) was the commonest variant (57%), followed by acute motor axonal neuropathy (AMAN, 21%) and acute sensorimotor
axonal neuropathy (AMSAN, 19%). There was no statistically significant association between age, gender, type of GBS, mode of treatment and
final outcome, though IvIg and plasmapheresis decreased the mean duration of hospital stay by approximately 10 days compared to those managed
conservatively alone.
Conclusion: Areflexia and quadriparesis were the commonest presenting features. IVIg and plasmapheresis hasten recovery but did not alter the
outcome.


Keywords


Guillain-Barré syndrome, Clinical profile, AIDP, AMAN, AMSAN, Miller-Fisher Variant, Adults, IvIg, Plasmapharesis.

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