Guillain-Barre, Syndrome: Clinical Profile

Abstract

Guillain–Barré Syndrome (GBS) is an acute, immune-mediated polyradiculoneuropathy and an important cause of acute flaccid paralysis (AFP) worldwide. Respiratory insufficiency requiring v entilator occurs in 30% of patients that prolong the hospital stay, leading to morbidity and mortality. There had been relatively few studies of Guillain-Barresyndrome in adults from North India. Objective:  To evaluate clinical profile, epidemiological, laboratory and electro-diagnostic feature of patients with Guillain Barre Syndrome in adults and use of intravenous immunoglobulin (IVIg) in addition to supportive care. Materials and Methods:  This was a prospective study of 50 patients with GBS admitted to our medicine department in rural tertiary care institution Dr.RPGMC Tanda.  We studied the epidemiological, clinical, electrophysiological features and their outcome.Result  In our study 50 cases were taken, motor weakness was the most common presenting feature. Antecedent illness was found in 48% of cases in the preceding two weeks, which included  nonspecific illness, acute respiratory infection, diarrhea, and viral infection like chickenpox.  At onset, sensory symptoms (pain and paresthesia) were noted in 16% of the cases and limb weakness in 77%. On admission, a majority (64%) was in Hughes neurological disability grading stage III-IV’ all had limb weakness at the peak deficit; autonomic disturbance was seen in 35.8%, and bulbar palsy in 6%. Duration of illness was less than three weeks in 60% of cases. The one patient had undergone repiratory distress and kept on ventilator for  23 days and survived. Conclusions: Male preponderance and motor weakness was the most common presenting illness and a majority achieved full recovery in our study. Although IVIg may be useful in the treatment of GBS, the key issue is excellent intensive care unit management.