Clinical features and outcome of Guillain–Barre syndrome in Saudi Arabia: a multicenter, retrospective study

Abstract

Background Guillain–Barre syndrome (GBS) is an inflammatory polyradiculoneuropathy characterized by rapidly evolving weakness and areflexia, reaching nadir within 4 weeks. Data on the characteristic of GBS in Saudi Arabia are limited. This study aimed to describe the clinical, electrophysiological, and laboratory characteristics and outcome of a multicenter cohort of patients with GBS. Methods This is a retrospective multicenter nationwide study. Patients who had GBS, identified through Brighton Criteria, between January 2015 and December 2019 were included. Data collected included demographics, clinical features, cerebrospinal fluid profile, reported electrophysiological patterns, treatment, and outcome. Reported GBS subtypes were compared using chi-square, Fisher's exact, or Mann–Whitney U tests, as appropriate. Results A total of 156 patients with GBS were included (men, 61.5%), with a median age of 38 (interquartile range, 26.25–53.5) years. The most commonly reported antecedent illnesses were upper respiratory tract infection (39.1%) and diarrhea (27.8%). All but two patients (98.7%) had weakness, 64.1% had sensory symptoms, 43.1% had facial diplegia, 33.8% had oropharyngeal weakness, 12.4% had ophthalmoplegia, and 26.3% needed mechanical ventilation. Cytoalbuminological dissociation was observed in 69.1% of the patients. GBS-specific therapy was administered in 96.8% of the patients, of whom 88.1% had intravenous immunoglobulin, and 11.9% had plasmapheresis. Approximately half of the patients were able to walk independently within 9 months after discharge, and a third regained the ability to walk independently thereafter. Death of one patient was caused by septicemia. Acute inflammatory demyelinating polyradiculoneuropathy was the most commonly reported GBS subtype (37.7%), followed by acute motor axonal neuropathy (29.5%), and acute motor-sensory axonal neuropathy (19.2%). Conclusion The clinical and laboratory characteristics and outcome of GBS in the Arab population of Saudi Arabia are similar to the international cohorts. The overall prognosis is favorable.

The relationship between serum cystatin C levels and Hughes motor scale in Guillain-Barré syndrome

“…About half of the patients had a history of infection within 6 weeks before the disease, and most of the infections were upper respiratory tract or gastrointestinal infections. In our study, patients’ symptoms reached peak disability at an average of 7 (4–10) days, slightly less that described by Wang et al 9 and consistent with Paul et al 10 …”

“…About half of the patients had a history of infection within 6 weeks before the disease, and most of the infections were upper respiratory tract or gastrointestinal infections. In our study, patients' symptoms reached peak disability at an average of 7 )4-10( days, slightly less that described by Wang et al 9 and consistent with Paul et al 10 In terms of electrophysiology, two-thirds of the patients in this study were found to have a demyelinating variant, and an axonal variant that included AMAN and AMSAN was less but also a quarter. According to reports, 5% of GBS in North America and Europe are axonal variant, while this variant is much more common in Northern China, Japan and the rest of America.…”

Electrodiagnostic referrals and neuromuscular disease pattern in East Africa: Experience from a tertiary hospital in Ethiopia

“…They also reported that the AMAN subtype was significantly associated with a history of antecedent diarrhea, longer duration of hospitalization, and slightly slower recovery than AIDP cases. On the other hand, a multicentre study from Saudi Arabia ( Alanazy et al, 2021 ) reported that AIDP was the commonest variant (37.7%) followed by AMAN and AMSAN subtypes in 29.5% and 19.2%, respectively. The international Guillain-Barré Syndrome Outcome Study, a multi-national cohort study in different regions of the world, also reported that demyelinating subtypes of GBS were the most prevalent EDX variant detected in all regions (Europe/Americas: 55%; Asia: 45% and Bangladesh: 40%) while the axonal subtype was predominant (36%) in Bangladesh ( Doets et al, 2018 ).…”

Guillain-Barre Syndrome Post COVID-19 Vaccination: Case Report

“…Data on GBS prevalence from Saudi Arabia is limited [6]. However, recently published retrospective multicenter study that included 156 patients with male to female ratio of 2.4:1 [7].…”