Subtypes and Prognosis of Guillain-Barré Syndrome in Southwest China

Abstract

The proportion of different subtypes of Guillain-Barré syndrome (GBS) and their prognosis varied significantly among different regions. This study attempts to investigate the clinical subtypes and outcome of GBS in southwest China. Patients with GBS admitted to The First Affiliated Hospital of Chongqing Medical University from January 2006 to March 2013 were included in our study. Patients were classified into acute inflammatory demyelinating polyneuropathy (AIDP) group, acute motor axonal neuropathy (AMAN) group, Miller-Fisher syndrome (MFS) group, cranial nerve variants(CNV), Bickerstaff's brainstem encephalitis overlaps with GBS (BBE-GBS) group and unclassifiable group based on clinical features and electrophysiological findings. Hughes function grade score (HFGS) was used to assess the prognosis at 3 and 6 months. The prognosis of different subtypes and outcome predictors were analyzed. The most common subtype of GBS was AIDP (57%), followed by AMAN (22%) and MFS (7%). The prognosis of AMAN and BBE-GBS is similar at 3 month(P = 0.0704)and 6 month (P = 0.1614) follow-up. The prognosis of AMAN group was poorer than that of AIDP group at 3 month and 6 month follow-up (P<0.001). Outcome of MFS group and that of CNV group at 6 months were both good(Hughes≤1). Hughes≥3(P<0.0001,OR = 6.650,95%CI = 2.865 to 15.023))and dysautonomia (P = 0.043,OR = 2.820,95%CI = 1.031 to 7.715)) were associated with poor outcome at 6 month follow-up. AIDP is the most common subtype of GBS. Prognosis of AMAN group and BBE-GBS group is poorer than that of AIDP group at 3 month and 6 month follow-up. Hughes≥3 at nadir and dysautonomia are predictors of poor prognosis at 6 month follow-up.

The utility of Guillain‐Barré syndrome prognostic models in Malaysian patients

“…In previous studies, axonal subtype of GBS has been associated with poor outcome. However, our study did not find significant associations between axonal GBS and poor outcome irrespective of which electrodiagnostic criteria used.…”

“…We also found that patients with MFS improved irrespective of immunotherapy, confirming findings from previous studies. 17,19 In previous studies, [20][21][22][23][24][25] axonal subtype of GBS has been associated with poor outcome. However, our study did not find significant associations between axonal GBS and poor outcome irrespective of which electrodiagnostic criteria used.…”

Prospective comparison of acute motor axonal neuropathy and acute inflammatory demyelinating polyradiculoneuropathy in 140 children with Guillain–Barré syndrome in India

“…A number of studies have compared triggering events, clinical characteristics, and outcomes in AMAN and AIDP . Most of these studies, however, were based on adult populations or included both adults and children.…”

“…11,13 A number of studies have compared triggering events, clinical characteristics, and outcomes in AMAN and AIDP. 15,17,[30][31][32] Most of these studies, however, were based on adult populations or included both adults and children. Among the studies comparing triggering events in AMAN and AIDP in children, 1 study from Japan found an association of gastroenteritis and GM1 antibody with AMAN and cranial nerve palsy with AIDP.…”

Guillain-Barré syndrome in southern China: retrospective analysis of hospitalised patients from 14 provinces in the area south of the Huaihe River

“…However, these kinds of generalisations may ignore regional differences, particularly the genetic and environmental differences between South China and North China, and thus lead to somewhat incorrect assessments 12. For example, unlike the data from northern China, a single-centre research conducted in southwest China has revealed that AIDP was the most common subtype (up to 57%) 13. In addition to affecting an individual’s susceptibility to develop a specific subtype of GBS, regional differences may also influence the course and severity of disease 3.…”