Clinical and Epidemiologic Features of Guillain‐Barré Syndrome

Hughes, Richard; Rees, Jeremy

doi:10.1086/513793

Cited by 418 publications

(324 citation statements)

References 39 publications

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“…On admission, n a d i r, 7, 60 and 365 days after treatment, disability scores are resumed in Table 2. Duration of hospitalization was also shown in this Table. Adverse events of PFX included central venous catheter related complications (3 patients), electrolyte disturbance (1) and hypotension (2). In cont r a s t , neither of the IVIg patients had any complication.…”

Section: Resultsmentioning

confidence: 99%

Guillain-Barré syndrome in the elderly: clinical, electrophysiological, therapeutic and outcome features

França

Deus-Silva

Castro

et al. 2005

Arq. Neuro-Psiquiatr.

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-There are few papers devoted to geriatric Guillain-Barré (GBS) and many related issues re m a i n u n a n s w e re d . Objective: To describe clinical, electrophysiological and therapeutic features in this age. Method: Clinico-epidemiological data and therapy of GBS patients older than 60 years were reviewed. Hughes scores were used to quantify neurological deficit and define outcome. Results: Among 18 patients (mean age 64.8 years), 9 had evident pro d rome and 80% noticed initially sensory-motor deficit. Demyelinating GBS was found in 8 and axonal in 6 subjects. There was one Miller-Fisher and 3 unclassified cases. Plasmapheresis (PFX) was single therapy in 12 patients and intravenous immunoglobulin (IVIg) in 2. Disability scores just before therapy were similar in both groups, so as short and long term outcome. C o n c l usion: Axonal GBS seems to be more frequent in the elderly and this may have prognostic implications. PFX and IVIg were suitable options, but complications were noticed with PFX. Prospective studies are needed to better understand and manage GBS in the elderly.KEY WORDS: Guillain-Barré syndrome, plasmapheresis, intravenous immunoglobulin, elderly.S í n d rome de Guillain-Barré no idoso: aspectos clínico-eletrofisiológicos, terapêutico e pro g n ó stico RESUMO -Publicações sobre a síndrome de Guillain-Barré (SGB) no idoso são escassas e várias questões s o b re o tema estão abert a s . O b j e t i v o :D e s c rever aspectos clínico-eletrofisiológicos, terapêuticos e pro g n ó stico no idoso. Método: Revisamos os prontuários de pacientes acima de 60 anos com SGB. A escala de Hughes foi usada para quantificar os déficits iniciais e finais. Resultados: No total de 18 pacientes (média de idade 64,8 anos), 50% tiveram pródromo e 80% tiveram déficit sensitivo-motor no início. SGB desmielinizante foi encontrada em 8 pacientes, axonal em 6 e uma síndrome de Miller-F i s h e r. Três casos não puderam ser classificados. Plasmaférese (PFX) foi empregada isoladamente em 12 pacientes e imunoglobulina endovenosa (IVIg) em 2. A disfunção inicial nos dois grupos tratados era semelhante, assim como a evolução a curto e longo prazo. Conclusão: A forma axonal da SGB parece ser mais freqüente no idoso e isto pode ter implicações prognósticas. PFX e IVIg foram eficazes, mas complicações ocorreram apenas no gru p o tratado com PFX. Estudos prospectivos são necessários para um melhor entendimento e manejo da SGB no idoso. PALAVRAS-CHAVE: síndrome de Guillain-Barré, plasmaférese, imunoglobulina endovenosa, idosos.

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Section: Resultsmentioning

confidence: 99%

Guillain-Barré syndrome in the elderly: clinical, electrophysiological, therapeutic and outcome features

França

Deus-Silva

Castro

et al. 2005

Arq. Neuro-Psiquiatr.

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“…To our knowledge, a seasonal preponderance in incidence has not been reported with significant difference. 1,[4][5][6]16,[19][20][21] Some of these studies show more cases in colder months. 16,21 One of the largest epidemiological studies conducted in southwest Netherlands 4 shows more cases during the winter and June, in Brazil a cluster of cases in spring and summer was reported 22 and in Sweden autumn was the season with most GBS cases.…”

Section: Discussionmentioning

confidence: 97%

“…4 GBS is often triggered by a preceding infection. 5,6 The most frequently described preceding infections are Campylobacter jejuni, cytomegalovirus (CMV), Epstein-Barr virus (EBV), and Mycoplasma pneumonia. [7][8][9][10][11] Flavivirus outbreaks regularly occur in the Caribbean.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of Guillain–Barré Syndrome in Aruba

Suryapranata

Ang

Chong

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. The epidemiology of Guillain-Barré syndrome (GBS) in tropical areas is different compared with developed countries. We investigated the epidemiology of GBS on the Caribbean island of Aruba. Data were collected retrospectively from all 36 patients hospitalized with GBS between 2003 and 2011 in Aruba. We observed a seasonal distribution of GBS cases with a peak in February. The incidence rate (IR) fluctuated heavily between individual years. The overall IR was 3.93/100,000, which is higher than that observed in developed countries. Serological studies indicated a possible relation of GBS cases with dengue virus infections. We also observed a relation between the annual number of dengue cases in Aruba and the number of GBS cases in the same year. We conclude that the epidemiology of GBS in tropical areas can be different from temperate climate regions and that dengue may be a trigger for developing GBS.

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“…[13][14][15] The patients usually have normal Babinski responses and normal bowel and bladder function. The natural history of most peripheral nerve lesions is that they involve sensory symptoms first and progress in a distal to proximal pattern.…”

Section: Faculty Discussionmentioning

confidence: 99%

“…[13][14][15] Peripheral nerve lesions are unlikely because our patient had a sudden onset of symptoms without progression and then a rapid resolution several hours later, which does not fit with a typical peripheral nerve pattern. [13][14][15] In addition, he did not have any paresthesias or fasciculations and although his reflexes were diminished, they were not absent.…”

Section: Faculty Discussionmentioning

confidence: 99%

Clinicopathological Conference Weakness in the Kneesx

McLaughlin

Buchsbaum

2000

Academic Emergency Medicine

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The patient was a previously healthy 23-year-old white man who presented to the emergency department (ED) complaining of sudden onset of complete lower extremity paralysis. He had felt completely normal that morning when he awoke, but realized he couldn't move his legs when he fell to the floor while trying to get out of bed. He was able to drag himself along the floor and call a friend, who brought him to the ED. He felt well the day prior and had begun to lift weights at the gym. He denied any recent back pain or trauma. He complained of ''sore'' and ''crampy'' legs and mild subjective arm weakness. He denied any fever, chills, or loss of bowel or bladder function. He had felt ''jittery'' recently, but attributed it to school stress. He had no history of heavy metal exposure, recent upper respiratory infection, or known tick bites. He denied any visual complaints, palpitations, dyspnea, cough, diarrhea, rashes, headaches, hearing loss, weight loss, night sweats, or dysuria.The patient had never been hospitalized or had any episodes of weakness. He was not taking any medications and denied medication allergies. His parents were healthy, and he had no children or siblings. There was no family history of any neurologic disease. He admitted to binge drinking alcohol twice a month to significant intoxication and smoked one to two packs of cigarettes a day for ten years. He huffed gasoline once three months ago, but denied inhaling any other substances or any other illicit drug use. He worked as an air conditioning repairman.On examination, the patient's heart rate was 100 beats/min, blood pressure 164/60 mm Hg, re- spiratory rate 20 breaths/min, temperature 36.2ЊC, and SaO 2 98% on room air. He was alert and slightly nervous. He had mild facial acne and an otherwise normal head and neck exam. Cardiac exam showed a regular rate and rhythm with a soft 1/6 systolic murmur at the left upper sternal border. His lungs were clear and the abdominal exam was normal. The rectal exam was normal. His extremities were warm, with normal pulses and no edema. The skin was slightly flushed. On neurologic exam he was alert and oriented, cranial nerves were intact, and his sensory exam was normal throughout. He had 5/5 strength in the upper extremities and 2ϩ/5 strength in the lower extremities. The deep tendon reflexes (DTRs) were depressed in the lower extremities. A Babinski reflex was not present and cerebellar testing was normal.The patient was admitted to the ED's observation unit, and a repeat neurologic exam six hours later demonstrated improved motor strength. Upper extremities were 5/5 strength and lower extremities had improved to 4ϩ/5. He was then noted to have 3ϩ DTRs throughout and one beat of clonus in bilateral Achilles' reflex. Neurology consult was obtained and the patient was admitted to the hospital for further studies. Results of magnetic resonance imaging (MRI) of his brain and spinal cord were normal. His chest x-ray and electrocardiogram were normal. His complete blood count was normal and a chemistry panel fr...

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Clinical and Epidemiologic Features of Guillain‐Barré Syndrome

Cited by 418 publications

References 39 publications

Guillain-Barré syndrome in the elderly: clinical, electrophysiological, therapeutic and outcome features

Guillain-Barré syndrome in the elderly: clinical, electrophysiological, therapeutic and outcome features

Epidemiology of Guillain–Barré Syndrome in Aruba

Clinicopathological Conference Weakness in the Kneesx

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