European Journal of Molecular & Clinical Medicine

Abstract

Introduction: Guillain–Barre Syndrome (GBS) is an acute, immune-mediated
polyradiculoneuropathy with a diverse clinical course and outcome and is the most
common cause of acute flaccid paralysis in the adult population.
Aim: To study the clinical profile, treatment response of GBS patients and to see their
association with electrophysiological subtypes of GBS.
Materials and Methods: We conducted a retrospective study of patients with Guillain-
Barre syndrome, presented at Sri Aurobindo Medical College and PG Institute, a
tertiary care centre in Madhya Pradesh, Central India, from January 2013 to January
2020. All patients diagnosed with Guillain-Barre syndrome were included in this study.
The handwritten case record files of the study population were retrieved from medical
record section of the institute.
Results: There were 70 patients with a male to female ratio of 1.4:1 and 70 % of them
were < 40 years of age. Antecedal infections were the preceding events in 31/70(44.3%).
Cranial nerve involvement was found in 25/70(17.5 %), 36/70(25.2%) patients had
dysautonomia and 17 (24.3%) cases requiring ventillatory support. The commonest
sub-type was acute inflammatory polyradiculoneuropathy 40(57.1%). Fever was seen in
more numbers of AIDP patients and preceeding GI symptoms were more seen in
AMAN and AMSAN variants . Autonomic dysfunction and need of ventillatory support
were more in axonal variants of GBS patients. High EGRIS score and long duration of
hospital stay were seen in axonal variant of GBS. Shorter duration of illness, rapidly
progressive motor weakness of the limbs, longer duration of hospital stay, cranial nerve
involvement, bladder dysfunction ,autonomic involvement, low MRC score(≤ 30), high
EGRIS score(> 4),high HDS score on admission were prone for ventillatory support.
Age >40 years, non treatment with immunomodulators, higher mEGOS on admission
were associated with poor outcome on discharge.
Conclusion: Early recognition of these risk factors helps in more vigilant management
of patients associated with high morbidity who are eligible for additional treatment in
future. AIDP variant is more common in our region and poor prognosis and long
hospital stay for AMAN and AMSAN variants of GBS.