Guillain-barré syndrome: A series observed at riyadh armed forces hospital january 1984–January 1994

Abstract

A consecutive series of 47 hospitalized cases of Guillain-Barre syndrome seen over a 10-year period was analysed with respect to: (1) age and sex; (2) antecedent events and seasonal distribution; (3) patterns of clinical presentation; (4) CSF and neurophysiological findings; (5) results of treatment with plasma exchange; and (6) outcome. Twenty-two were children, 20 middle-aged and 5 aged; 37 were male and 10 were female. The most frequent antecedent event was upper respiratory tract infections; a seasonal peak incidence was found in winter. Clinical, CSF and neurophysiological findings concurred with those in the Western literature; 79% of the cases were severe. Plasma exchange performed within the first 2 weeks of onset benefitted in the short-term outcome, i.e. improvement by 1 grade at 4 weeks, but the long-term benefit, i.e. the ability to regain independent locomotion, was questionable. Plasma exchange helped in curtailing the time to walking unaided but had no benefit on the duration of artificial ventilation. Factors associated with an adverse outcome were: age over 15 years, severity of motor electrodiagnostic findings (especially a decreased distal CMAP amplitude and EMG signs of acute denervation), requirement for ventilation and slow progression (>3 weeks) to maximum deficit. After a mean follow-up of 11 months, 55% of the patients regained independent locomotion, which is a comparatively low proportion.

Epidemiology of childhood Guillan-Barre syndrome in the north west of Iran

“…However if we exclude the cases from year 2003, our incidence rate decrease to 2 cases per 100 000 population which is consistent with other reports [5-8,11,12]. …”

“…A research report from China indicated that summer epidemics of the syndrome might be caused by campylobacter jejuni infection [21]. In a study from Saudi Arabia, analysis of seasonal incidence has also shown that 40% of the cases occurred in the cold seasons with the highest peak in February [12]. In our study, clustering of patients in winter could be related to the high frequency of upper respiratory infection during cold season.…”

Clinical and Neurophysiological Pattern of Guillain-Barré Syndrome in Kuwait

“…GBS is a nonseasonal disease [9,12] but seasonal clustering has been reported during summer in Northern China [13] , spring in Taiwan [14] and winter and spring (September to March) in the Arabian Gulf region [8,11] and in the present study during the winter months of November to March.…”

Long term disability and social status change after Guillain–Barré syndrome

“…Previous studies trying to identify the incidence of disability after Guillain-Barré reported residual signs and symptoms in 16 % to 54 % of the patients [2,6,13,17,[20][21][22]. These at times high frequencies of residual disability might be explained by the relatively short follow-up in these studies (mean follow-up 1 year), since recovery in GBS has been reported to continue up to 2 years [3,8].…”

“…The following clinical prognostic features [2,6,13,17,[20][21][22] were assessed in relation to long term disability: age of onset, sex, degree and time to maximal impairment, duration of plateau phase, time to onset of recovery, motor, sensory, respiratory and cranial nerve impairment, and treatment. We also assessed the following laboratory data obtained during the acute phase: increased CSF protein levels (> 50 mg/dL); serum anti-ganglioside GM1, GD1a, GM2 and GQ1b IgG antibodies (> 1/320) by enzyme-linked immunoabsorbent assay (ELISA) [4]; serum anti-Campylobacter jejuni antibodies by ELISA and immunoblot [19]; serum antibodies to the following virus measured by ELISA according to manufacturers' instructions: HSV-1/HSV-2 IgG (Herpes 1/2 IgG, Bio-Rad Lab., Milan, Italy) and IgM (HSV IgM, Bio-Rad); CMV IgG (CMV IgG, Bio-Rad) and IgM (CMV IgM, Bio-Rad).…”