Spectrum of Guillain Barre syndrome in a teaching hospital of North Karnataka

Abstract

Guillain-Barre ́ syndrome (GBS) is an acute onset, immune-mediated polyneuropathy that often follows an antecedent infection. The diagnosis is based on the clinical impression obtained from the history and examination. Cerebrospinalfluid analysis and electro diagnostic testing usually provide evidence supportive of the diagnosis. Objectives: To study clinical presentation, treatment and outcome of patients with Guillain Barre Syndrome (GBS). Material and Methods: 20 patients of GBS studied in detail including history, clinical examination and investigations. Those who developed respiratory insufficiency were given assisted mechanical ventilation. Patients were treated with IVIG or plasmapheresis and outcome was observed. Results: Commonest age group affected was 16-40 yrs. The male: female ratio was 1.2:1. Antecedent infection was present in 6 out of 20 patients. 14 patients had quadriparesis and paraparesis in 6 patients. Cranial nerve involvement was seen in 5 patients. Areflexia was found in all patients. NCV findings show conduction velocity slowing, delayed f latencies in 90% patients. Out of 20 patients, 5 required mechanical ventilation. Out of 20 patients, 13 patients received only supportive treatment, 7 were treated with IVIg, 3 patientstreated with plasmapheresis. Out of 20 patients, 16patients recovered completely, 2 patients expired and 2 patients developed neurologic deficit. Conclusion: GBS is more common in 16-40 yrs age group with male:female ratio of 1.2:1. Antecedent infection is seen in 30% patients. Commonest presentation was ascending paralysis. 25%patients developed respiratory paralysis and needed ventilatory support.