Trends in Clinical and Medical Sciences
Special issue: Recent developments of medical and surgical research (2023), pp. 242 – 249
ISSN: 2791-0814 (online) 2791-0806 (Print)
DOI: 10.30538/psrp-tmcs2023.si-rdmsr033
ISSN: 2791-0814 (online) 2791-0806 (Print)
DOI: 10.30538/psrp-tmcs2023.si-rdmsr033
Clinical and electrophysiological study of Guillain-Barre’ syndrome with reference to prognosis-A hospital-based study
Chandan Kumar Gantayat\(^{1}\), Nrusingha Charan Dash\(^{2}\), Prashant Kumar Panda\(^{3}\) and Bibhujit Padhy\(^{4,*}\)
\(^{1}\) Department Of Internal Medicin, MKCG Medical college & Hospital, Berhampur, Odisha.
\(^{2}\) Department Of Respiratory Medicine, SCB Medical college & Hospital, Cuttack, Odisha.
\(^{3}\) Department Of Ophthalmology, VSS Medical College & Hospital, Burla, Sambalpur, Odisha.
\(^{4}\) Department of Emergency Medicine, MKCG Medical College & Hospital, Berhampur, Odisha.
Correspondence should be addressed to Bibhujit Padhy at b12padhy@gmail.com
Copyright © 2023 Chandan Kumar Gantayat, Nrusingha Charan Dash, Prashant Kumar Panda and Bibhujit Padhy. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: December 29, 2022 – Accepted: April 1, 2023 – Published: April 16, 2023
Abstract
Introduction: Guillain-Barre Syndrome (GBS) is an acute and often severe polyradiculoneuropathy caused by autoantibody-mediated destruction of the myelin sheath, which presents with ascending paralysis and areflexia. The mortality rate of GBS is less than 5%. We conducted a study in our hospital to identify the epidemiological features, clinical profile, and electrophysiological features of GBS and to determine the various GBS variants present in the studied population. We also aimed to correlate the prognosis of GBS with age, critical time period, and requirements for ventilatory support.
Methods: We conducted a cross-sectional analytical study of 32 adult patients (age > 20 years) meeting the criteria for GBS after a detailed study and 3-month follow-up.
Results: GBS occurred in 71.87% males, mostly in those over 50 years of age. Antecedent events were present in 65.26% of patients, with respiratory tract infections being the most common (43.75%). The most common initial motor symptom was distal weakness (28.12%) with ascending progression. The most commonly involved cranial nerve was the facial nerve (49.99%). Twenty-two patients (68.65%) had a disability grade of 3 at peak. Ten patients developed respiratory weakness, with acute motor axonal neuropathy (AMAN), acute motor and sensory axonal neuropathy (AMSAN), and acute inflammatory demyelinating polyneuropathy (AIDP) cases being 4 (40%), 3 (30%), and 2 (20%), respectively. Postural hypotension was the most common autonomic dysfunction (12.5%). AIDP (71.87%) was the most common variant, and aspiration pneumonia (18.75%) was the most common complication in patients requiring mechanical ventilation (60% of ventilator-assisted patients developed aspiration pneumonia), while urinary tract infection (UTI) (3 cases, 9.37%) was the most common complication in non-ventilator-associated patients. Intravenous immunoglobulin (IVIG) was found to be beneficial, with a 72% recovery rate.
Conclusion: GBS is a disease that primarily affects adult males, with a rapid onset to peak, prolonged duration at peak, need for assisted ventilation, and axonal pattern being poor prognostic factors.
Methods: We conducted a cross-sectional analytical study of 32 adult patients (age > 20 years) meeting the criteria for GBS after a detailed study and 3-month follow-up.
Results: GBS occurred in 71.87% males, mostly in those over 50 years of age. Antecedent events were present in 65.26% of patients, with respiratory tract infections being the most common (43.75%). The most common initial motor symptom was distal weakness (28.12%) with ascending progression. The most commonly involved cranial nerve was the facial nerve (49.99%). Twenty-two patients (68.65%) had a disability grade of 3 at peak. Ten patients developed respiratory weakness, with acute motor axonal neuropathy (AMAN), acute motor and sensory axonal neuropathy (AMSAN), and acute inflammatory demyelinating polyneuropathy (AIDP) cases being 4 (40%), 3 (30%), and 2 (20%), respectively. Postural hypotension was the most common autonomic dysfunction (12.5%). AIDP (71.87%) was the most common variant, and aspiration pneumonia (18.75%) was the most common complication in patients requiring mechanical ventilation (60% of ventilator-assisted patients developed aspiration pneumonia), while urinary tract infection (UTI) (3 cases, 9.37%) was the most common complication in non-ventilator-associated patients. Intravenous immunoglobulin (IVIG) was found to be beneficial, with a 72% recovery rate.
Conclusion: GBS is a disease that primarily affects adult males, with a rapid onset to peak, prolonged duration at peak, need for assisted ventilation, and axonal pattern being poor prognostic factors.
Keywords:
G.B.S.; Polyradiculoneuropathy; Autoimmune disorder; Respiratory tract infections; IVIG treatment.