"Clinical, electrophysiological findings and evaluation of prognosis of patients with Guillain-Barré syndrome"

Abstract

Abstract:Guillain-Barré syndrome (GBS) is an acute inflammatory polyneuropathycharacterized by frequent rapid progressive, ascending, symmetric weakness andareflexia. We aimed to evaluate the etiology, clinical and electrophysiologicalfindings with treatment and prognosis of the patients with GBS in our clinic.Patients who were diagnosed with GBS in our clinic between 2009 and 2017were evaluated retrospectively. The study included 20 female and 25 malepatients. The most frequent symptom was the absence of walking (95.5%).All of the patients had muscle weakness on examination; in addition to thathyperesthesia (31%), autonomic symptoms (13.3%), sensory loss (11.1%),ataxia (11.1%), bilateral facial nerve palsy (6.6%), oculomotor nerve palsy(2.2%), and multiple cranial nerve involvement (2.2%) were the otherdetected findings. Ventilation support was required in 6 cases (13.3%).Acute motor axonal neuropathy (AMAN) was found in 20 patients (44.5%),acute inflammatory demyelinating polyradiculoneuropathy (AIDP) was foundin 24 patients (53.3%), and acute motor and sensory axonal neuropathy(AMSAN) was only present in 1 patient (2.2%). Intravenous immunoglobulin(IVIG) was administered to 33 of the patients (73.3%). The mean hospitalstay was 8.4±3.5 (2-17 days), and the relationship between the duration ofhospital stay and the treatment given was statistically significant (p = 0.001).Complete remission was observed in 37 patients (82.3%) and the remaining5 children (11.1%) experienced incomplete recovery. Three patients (6.7%)died of treatment-resistant hypotension, arrhythmia and severe pulmonaryinfection. The short duration of neurological deficit following infection, clinicalstage of application, need for mechanical ventilation, dysautonomia, cranialnerve involvement, and current subtype were the negative prognostic factors.Although GBS is a self-limiting disease, early diagnosis and treatment arevery important to reduce hospital stay with morbidity and mortality. Patientsexpected to be at high risk should be monitored closely.