Guillain-Barré syndrome

Chiò, Adriano; Cocito, Dario; Leone, Maurizio; Giordana, Maria Teresa; Mora, Gabriele; Mutani, Roberto; Syndrome, Valle d’Aosta Register for Guillain-Barré

doi:10.1212/01.wnl.0000055091.96905.d0

Cited by 209 publications

(175 citation statements)

References 38 publications

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“…Similar finding were reported by Bhargava et al 10 Mean CSF protein was 80.27mg/dl and is comparable to studies by Chio et al 21 and Corston et al 22 Mortality in GBS is associated with respiratory failure requiring mechanical ventilation that prolongs hospital stay. To detect early respiratory failure, all cases with Hughes grade 4 and those with MRC sum score suggestive of moderate (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) and severe (0-10) motor deficit were assessed intensively for early respiratory failure. Battery of tests included were baseline measurement of peripheral saturation (Sao2), single breath count (SBC), peak expiratory flow meter and dysphagia tests.…”

Section: Discussionsupporting

confidence: 90%

Guillain-Barré syndrome: Clinical profile and Consensus to revise Hughes grade 5

Manorenj¹,

Inturi²,

Bhargava³

et al. 2016

IJMEDPH

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Background: Guillain-Barré Syndrome (GBS) is an acute, immune-mediated polyradiculoneuropathy and an important cause of acute flaccid paralysis (AFP) worldwide. Respiratory insufficiency requiring ventilator occurs in 30% of patients that prolong the hospital stay, leading to morbidity and mortality. There had been relatively few studies of Guillain-Barre syndrome in adults from South India. Aim: To evaluate clinical profile, epidemiological, laboratory, and electro diagnostic features of patients with GBS in adults. Settings and design: A prospective study was conducted over a period of 4 years at ESIC Superspeciality Hospital, Hyderabad. Materials and methods: Total 36 patients were identified and data was collected. We studied the epidemiological, clinical, electrophysiological features and their outcome. We subdivided Hughes grade 5 into 5A and 5B based on the requirement of ventilator. Statistical Analysis: Data obtained in the study were subjected to statistical analysis with Statistical Package for Social Sciences (SPSS) version 18. Bivariate analysis was done using chi-square test. Results: Of 36 GBS patients, 21(58.3%) were males; the mean age was 35 years. Antecedent infection was found in 23(63.8%). Majority 12 (33%) were in Hughes grade 4, 10 (27.7%) were in Hughes grade 5A. 97.2% had limb weakness. A significant association was found between low Medical research sum score (MRC) and respiratory failure. Most predominant neurophysiological variant was acute inflammatory demyelinating polyradiculoneuropathy (AIDP) 12 (33.3%). Duration of illness was less than 1week in 19 (52.7%) of cases. Asymmetry was observed in 5 (13.8%) and recurrence of Guillain-Barre Syndrome seen in 2 (5.5%) cases. Complete recovery was noted at 6 months in 34 (94.4%) cases. Conclusion: Early diagnosis of respiratory failure and prompt intervention improves patient outcome. Further large sample studies are required to assess respiratory failure and subdivision of Hughes grade 5.

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Section: Discussionsupporting

confidence: 90%

Guillain-Barré syndrome: Clinical profile and Consensus to revise Hughes grade 5

Manorenj¹,

Inturi²,

Bhargava³

et al. 2016

IJMEDPH

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“…The incidence of GBS has been reported to be 1-2 per 100,000 in the general population. [1][2][3] A mild respiratory or gastrointestinal tract infection precedes onset of symptoms in 75% of patients with GBS. 4,5 It has been suggested that surgical procedures, lymphoma, and systemic lupus erythematosus may also be predisposing conditions for GBS.…”

mentioning

confidence: 99%

Redefining the Guillain-Barré Spectrum in Children: Neuroimaging Findings of Cranial Nerve Involvement

Zuccoli¹,

Panigrahy²,

Bailey³

et al. 2011

AJNR Am J Neuroradiol

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SUMMARY: GBS and its MFS variant are acute polyneuropathies that are considered to represent a continuum rather than distinct entities, due to the overlap in their clinical features. Enhancement of the CE roots represents the neuroradiologic hallmark of GBS, while findings of neuroimaging studies in MFS are usually unremarkable. Our purpose was to evaluate the MR imaging findings of polyneuropathy in 17 children affected by GBS and its MFS variant. Fourteen of our 17 patients demonstrated CE enhancement, with predominant involvement of the anterior roots. Of 6 patients who underwent MR imaging of the brain, 5 had cranial nerve involvement. In children affected by GBS-MFS, involvement of the CE roots may be considered part of a more extensive autoimmune neuropathy, as demonstrated by enhancement of cranial nerves. Brain MR imaging should be considered in the routine evaluation in pediatric patients with GBS-MFS for the evaluation of the cranial nerves.

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“…The diagnosis of AIDP/GBS depends on the appropriate clinical presentation with ascending weakness and the finding of areflexia. By definition, patients should present within 4 weeks of symptom onset, although the mean time from symptom onset to maximal symptoms is approximately 10 days [88]. CSF analysis usually reveals elevated protein and few cells (cytoalbuminemic dissociation).…”

Section: Guillain-barré Syndromementioning

confidence: 99%

“…IVIG is a reasonable alternative to plasmapheresis, and the data do not support the superiority of one treatment over another [23,98]. Despite improvement in ICU care and advances in immunotherapy, the mortality in patients with AIDP/GBS are still at least 2 to 3%, and may even approach 10% [88,[101][102][103]. Advanced age and the presence of medical comorbidities are the most potent predictors of poor outcome [104][105][106].…”

Section: Guillain-barré Syndromementioning

confidence: 99%

Immune Mediated Diseases and Immune Modulation in the Neurocritical Care Unit

Geldern¹,

McPharlin

Becker

2012

Neurotherapeutics

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This chapter will review the spectrum of immunemediated diseases that affect the nervous system and may result in an admission to the neurological intensive care unit. Immunomodulatory strategies to treat acute exacerbations of neurological diseases caused by aberrant immune responses are discussed, but strategies for long-term immunosuppression are not presented. The recommendations for therapeutic intervention are based on a synthesis of the literature, and include recommendations by the Cochrane Collaborative, the American Academy of Neurology, and other key organizations. References from recent publications are provided for the disorders and therapies in which randomized clinical trials and large evidenced-based reviews do not exist. The chapter concludes with a brief review of the mechanisms of action, dosing, and side effects of commonly used immunosuppressive strategies in the neurocritical care unit.

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Guillain-Barré syndrome

Abstract: After adjustment to US population, the incidence rates for GBS from different countries showed no significant differences. Both acute mortality and long-term disability in GBS seem to be related to an axonal involvement and a Hughes grade >or=2 at nadir.

Cited by 209 publications

References 38 publications

Guillain-Barré syndrome: Clinical profile and Consensus to revise Hughes grade 5

Guillain-Barré syndrome: Clinical profile and Consensus to revise Hughes grade 5

Redefining the Guillain-Barré Spectrum in Children: Neuroimaging Findings of Cranial Nerve Involvement

Immune Mediated Diseases and Immune Modulation in the Neurocritical Care Unit

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