Clinical Features and Outcome of the Guillain–Barre Syndrome: A Single-Center 11-Year Experience

Abstract

BackgroundClinical presentation, electrophysiological subtype, and outcome of the Guillain–Barre' Syndrome (GBS) may differ between patients from different geographical regions. This study aims to assess clinical–neurophysiological features of an adult, Italian GBS cohort over 11 years.MethodsRetrospective (from 1 January 2011 to 31 December 2021) analysis was carried out on patients admitted to the Siena University Hospital who fulfilled the GBS diagnostic criteria. Demographic data, clinical characteristics, treatment, need of mechanical ventilation (MV), laboratory and electrophysiological tests, preceding infections/vaccination/other conditions, and comorbidities were collected for each patient.ResultsA total of 84 patients (51 men, median age of 61 years), were identified. GBS subtype was classified as acute inflammatory demyelinating polyneuropathy (AIDP) in the 66.6% of patients, acute motor/sensory axonal neuropathy (AMAN/AMSAN) in 20.2%, and the Miller Fisher syndrome in 5 (5.9%). Flu syndrome and gastrointestinal infection were the most common preceding conditions. In total, five (5.9%) subjects had concomitant cytomegalovirus (CMV) infection. Cranial nerve involvement occurred in 34.5% of subjects. Differences between the axonal and AIDP forms of GBS concerned the presence of anti-ganglioside antibodies. In total, seven (8.33%) patients required MV.DiscussionThe epidemiological and clinical characteristics of GBS in different countries are constantly evolving, especially in relation to environmental changes. This study provides updated clinical-epidemiological information in an Italian cohort.

Guillain–Barré Syndrome in Northern China: A Retrospective Analysis of 294 Patients from 2015 to 2020

“…A similar conclusion was found in other regions worldwide [ 2 ]. However, in the early 1990s, GBS patients were mainly children and young adults, which indicated that the onset age of GBS has changed [ 22 ].…”

“…There were regional differences in the seasonality of GBS [ 23 ]. The incidence of GBS patients was higher in winter in Australia [ 20 ], Italy [ 22 ], and spring in Greece [ 23 ]. In our study, an increased incidence of GBS was observed in summer and autumn, which was consistent with the report in the 1990s [ 9 ] and the report by Islam et al [ 24 ].…”

The early clinical and laboratory predictors of GBS outcome: hospital-based study, Assiut University, Upper Egypt

“…Involvement of cranial nerves was observed in 40 patients (64.5%) with either unilateral or bilateral facial palsy, bulbar palsy or both but neither correlated with outcome. Other studies reported a lower incidence of cranial nerve involvement ranging from 25 to 34% [21,22,35,36], while several previous reports found that involvement of cranial nerves was more common in severe forms of GBS and was associated with poor prognosis [27,28,31]. Verma, Chaudhari, Raut and colleagues found that cranial nerve involvement was associated with mechanical ventilation [36].…”

COVID‐19 as a trigger of Guillain‐Barré syndrome: A review of the molecular mechanism

“…Since most of the COVID‐19‐related GBS cases reported a demyelinating variant of GBS 38 and antibodies have a significant impact on the COVID‐19 pathogenesis, 74 it can be anticipated that antibodies may have a critical role in post‐COVID GBS pathogenesis. However, anti‐ganglioside antibodies, the main auto‐antibodies against myelin that cause GBS, are more frequent in axonal forms of GBS 75 . Antiganglioside antibodies are low in post‐COVID‐19 GBS patients.…”