Indian Journal of Physical Medicine and Rehabilitation

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VOLUME 29 , ISSUE 2 ( 2018 ) > List of Articles


Guillain–Barré Syndrome: Profile of 120 Patients with respect to Response to Various Modalities of Treatment

Vishal A Chafale, Alak Pandit, Satish A Lahoti, Tajendranath Kundu, Goutam Ganguly

Keywords : Clinical profile, Guillain–Barré syndrome, Intravenous steroid, Prognosis, Treatment.

Citation Information : Chafale VA, Pandit A, Lahoti SA, Kundu T, Ganguly G. Guillain–Barré Syndrome: Profile of 120 Patients with respect to Response to Various Modalities of Treatment. Indian J Phy Med Rehab 2018; 29 (2):31-36.

DOI: 10.5005/jp-journals-10066-0022

License: CC BY-ND 3.0

Published Online: 01-06-2018

Copyright Statement:  Copyright © 2018; The Author(s).


Introduction: Guillain–Barré Syndrome (GBS) is an inflammatory polyradiculoneuropathy with varied clinical manifestation and often dismal prognosis if not promptly treated. Recommended treatment modalities [intravenous immunoglobulin (IVIG) and plasma exchange (PE)] are costly and the role of steroids is controversial. Materials and methods: In this study, we reviewed the clinical and laboratory findings of consecutive patients with GBS (n = 120) and explored factors associated with outcome. We also compared response to different modalities of treatment including steroids. Results: There was no significant difference between the treatment outcomes of IVIG and PE and we found a nonsignificant trend toward improvement with intravenous (IV) steroid. We observed 4.17% mortality and most common cause of death was respiratory failure. Conclusion: Increasing age, delay in starting treatment, early peak disability, autonomic dysfunction, bulbar weakness, and reduced compound muscle action potential (CMAP) were associated with a poorer outcome. Group of patients treated with IVIG and plasmapheresis showed more improvement than the IV methylprednisolone group.

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  1. Katirji B, Koontz D. Disorders of peripheral nerves. In: Daroff R, Jankovic J, Mazziotta JC, Pomeroy SL, editors. Bradlys neurology in clinical practice. 6th ed. Elsevier Saunders; 2012. pp. 1955-1963.
  2. Asbury AK, Cornblath DR. Assessment of current diagnostic criteria for Guillain-Barre Syndrome. Ann Neurol 1990;27 (Suppl):S21-S24.
  3. Ropper AH, Wijdicks EF, Truax BT. Guillain-Barre syndromecontemporary neurology series. Philadelphia: FA Davis; 1991.
  4. Yuki N, Hartung HP. Guillain. Barre syndrome. New Engl J Med 2012 Jun;366(24):2294-2304.
  5. Gnanamuthu C, Ray D. outcome of patients with fulminant Guillain-Barre syndrome on mechanical ventilatory support. Indian J Chest Dis Allied Sci 1992;34:65-72.
  6. Taly AB, Gupta SK, Vasanth A, Suresh TG, Rao U, Nagaraja D, Swamy HS, Rao S, Subbakrishna DK. Critically ill Guillain- Barre syndrome. J Assoc Physicians India 1994 Nov;42(11): 871-874.
  7. Guillain-Barre Syndrome Steroid Trial Group. Double-blind trial of intravenous methylprednisolone in Guillain-Barre syndrome. Lancet 1993 Mar;341(8845):586-590.
  8. Hughes RA, Newsom-Davis JM, Perkin GD, Pierce JM. Controlled trial prednisolone in acute polyneuropathy. Lancet 1978 Oct;2(8093):750-753.
  9. Sethi PK, Thukral R, Sethi NK, Torgovnick J. Is there a role of steroids in IVIG failed cases of Guillain-Barre syndrome? Internet J Neurol 2006;5(2).
  10. Winer JB. Treatment of Guillain Barre syndrome. QJM 2002 Nov;95(11):717-721.
  11. Kleyweg RP, van der Meche FG, Schmitz PI. Interobserver agreement in the assessment of muscle strength and functional abilities in Guillain-Barre syndrome. Muscle Nerve 1991 Nov;14(11):1103-1109.
  12. Kalita J, Misra UK, Goyal G, Das M. Guillain-Barré syndrome: subtypes and predictors of outcome from India. J Peripher Nerv Syst 2014;19:36–43.
  13. Suárez GI, Gallego SI, Javier F, Rivera R, Arpa J. Guillain-Barré syndrome: natural history and prognostic factors: a retrospective review of 106 cases. BMC Neurol 2013 Jul;13:95.
  14. Hughes RA, Cornblath DR. Guillain Barre syndrome. Lancet 2005 Nov;366(9497):1653-1666.
  15. Van Doorn PA, Ruts L, Jacobs BC. Clinical features, pathogenesis, and treatment of Guillain-Barré syndrome. Lancet Neurol 2008 Oct;7(10):939–950.
  16. McGrogan A, Madle G, Seaman HE, De Vries CS. The epidemiology of Guillain-Barré syndrome worldwide. Neuroepidemiology 2009;32(2):150–163.
  17. Lyu RK, Tang LM, Cheng SY, Hsa WC, Chen ST. Guillain-Barré syndrome in Taiwan: a clinical study of 167 patients. J Neurol Neurosurg Psychiatry 1997;63:494–500.
  18. Jin K, Keong W, Vaithialingam M. A clinical and electrophysiological study of Guillain-Barré syndrome in Malaysia. Neurol J Southeast Asia 1999;4:67-72.
  19. Yuki N, Kokubun N, Kuwabara S, Sekiguchi Y, Ito M, Odaka M, Hirata K, Notturno F, Uncini A. Guillain-Barré syndrome associated with normal or exaggerated tendon reflexes. J Neurol 2012 Jun;259(6):1181-1190.
  20. Kuwabara S, Ogawara K, Koga M, Mori M, Hattori T, Yuki N. Hyperreflexia in Guillain Barre syndrome: relation with acute motor axonal neuropathy and ant GM1 antibody. J Neurol Neurosurg Psychiatry 1999;67:180-184.
  21. Singhal V, Bhat KG. Guillain Barre syndrome with hyperreflexia: a variant. J Paediatr Neurosci 2011 Jul;6(2):144-145.
  22. Kuwabara S, Mori M, Ogawara K, Hattori T, Yuki N. Indicators of rapid clinical recovery in Guillain-Barre syndrome. J Neurol Neurosurg Psychiatry 2001;70:560-562.
  23. Arnason BG, Soliven B. Acute inflammatory demyelinating polyradiculoneuropathy: In: Dyck JP, Thomas PK, editors. Peripheral neuropathy. 3rd ed. Elsevier Saunders; 1997. pp. 1437-1474.
  24. An JY, Yoon B, Kim JS, Song IU, Lee KS, Kim YI. Guillain-Barré syndrome with optic neuritis and a focal lesion in the central white matter following Epstein-Barr virus infection. Intern Med 2008;47(17):1539-1542.
  25. Nadkarni N, Lisak RP. Guillain-Barré syndrome (GBS) with bilateral optic neuritis and central white matter disease. Neurology 1993 Apr;43(4):842-843.
  26. Ho TW, Mishu B, Li CY, Gao CY, Cornblath DR, Griffin JW, Asbury AK, Blaser MJ, McKhann GM. Guillain-Barré syndrome in northern China. Relationship to Campylobacter jejuniinfection and anti-glycolipid antibodies. Brain 1995 Jun;118(Pt 3): 597-605.
  27. Hughes RA, Swan AV, van Koningsveld R, van Doorn PA. Corticosteroids for Guillain-Barre syndrome. Cochrane Database Syst Rev 2006;(2):CD001446.
  28. Hughes RA, van der Meché FG. Corticosteroids for treating Guillain-Barré syndrome. Cochrane Database Syst Rev 2000;(2):CD001446.
  29. Van Koningsveld R, Schmitz PI, van der Meché FG, Visser LH, Meulstee J, van Doorn PA. Effect of methylprednisolone when added to standard treatment with intravenous immunoglobulin for Guillain-Barré syndrome: randomised trial. Lancet 2004 Jan;363(9404):192-196.
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