Clinical Course and Predictors of Poor Functional Outcome in Guillain-Barré Syndrome. A Retrospective Study

Introduction: Guillain-Barré syndrome (GBS) is the most common cause of acute flaccid paralysis. It carries great morbidity due to an overall high rate of poor functional outcome. This study is conducted to study the predictors of poor functional outcome. Methods: This study a retrospective observational study, which was conducted in Rashid Hospital Tertiary Center in Dubai between 2009 and 2019. Functional status was assessed and followed by the GBS disability score. Functional outcome at 6 months was evaluated for possible predicting factors as well as associated outcomes. Results: Out of the 82 cases, the mean age at presentation is 37 ± 14.4, with 64 (78%) males. Around one-third of cases (37.8%) had residual deficits at 6 months. Follow-up after 6 months showed that cases with a poor functional outcome are older (p = 0.035) and have presented with a high disability score (p < 0.001) and a higher need for mechanical ventilation (p < 0.001). Axonal type of nerve injury resulted in poor functional outcome at 6 months compared to the demyelinating type of nerve injury (p = 0.034). Lower rate of improvement at 1 month and poor functional outcome at 6 months resulted in a longer hospital stay (p < 0.001). Conclusion: A poor functional status at presentation, axonal type of nerve injury, and the early requirement for mechanical ventilation are found to predict poor functional improvement after 6 months from diagnosis. These factors must be kept in consideration to facilitate more vigilant management of patient’s associated high morbidity.

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Mechanical Ventilation in Guillain-Barré Syndrome: Does Age Influence Functional Outcome?

European Neurology ◽

10.1159/000210548 ◽

2009 ◽

Vol 61 (6) ◽

pp. 358-363 ◽

Cited By ~ 8

Author(s):

Martin Köhrmann ◽

Hagen B. Huttner ◽

Tim Nowe ◽

Peter D. Schellinger ◽

Stefan Schwab

Keyword(s):

Mechanical Ventilation ◽

Functional Outcome ◽

Guillain Barre Syndrome ◽

Guillain Barré Syndrome ◽

Influence Functional ◽

Guillain Barré

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Three-Year Follow-Up Study in Patients with Guillain-Barré Syndrome

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2018.12 ◽

2018 ◽

Vol 45 (3) ◽

pp. 269-274 ◽

Cited By ~ 3

Author(s):

Vesna Martic ◽

Ivo Bozovic ◽

Ivana Berisavac ◽

Ivana Basta ◽

Stojan Peric ◽

...

Keyword(s):

Functional Outcome ◽

Functional Disability ◽

Severe Disability ◽

Guillain Barre Syndrome ◽

Poor Functional Outcome ◽

Number Of Patients ◽

Guillain Barré Syndrome ◽

Tertiary Healthcare ◽

Guillain Barré

AbstractA majority of patients with Guillain-Barré syndrome (GBS) have tendency of a good recovery. Our aim was to evaluate the outcome of the disease 1 and 3 years after GBS symptom onset. Methods: During 2014, GBS was diagnosed in 82 patients in seven tertiary healthcare centers. Neurological follow-up was conducted in 57 (70%) patients after 1 year, and in 54 (66%) after 3 years. Functional disability was estimated according to the GBS disability scale (GDS), with a score of 0-3 indicating mild disability and a score of 4-6 indicating severe disability during acute phase, whereas a score >1 indicated poor recovery on follow-ups. Visual analog scale was used to assess sensory symptoms and musculoskelatal pain, and Krupp’s Fatigue Severity Scale was used to asses fatigue. Results: Poor functional outcome was found in 39% of GBS patients at year 1 and 30% at year 3. Paresthesias/dysesthesias were detected in 60% of patients after 1 year and 43% after 3 years. Musculoskeletal pain was present in 40% of patients at year 1 and 33% at year 3. Significant fatigue after 1 year was found in 21% of subjects and after 3 years in 7%. Parameters associated with poor functional outcome after 1 year were age >55 years (p=0.05), severe disability at admission (p<0.05), and on discharge (p<0.01). Poor functional outcome after 3 years was associated with male gender (p<0.05) and severe disability on discharge (p=0.06). Conclusion: One and even three years after GBS onset, a substantial number of patients had neurological sequelae, including functional disability, sensory symptoms, pain, and fatigue.

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Study on Guillain-Barré Syndrome in A Tertiary Level Military Hospital

Journal of Armed Forces Medical College Bangladesh ◽

10.3329/jafmc.v16i2.55297 ◽

2021 ◽

Vol 16 (2) ◽

pp. 44-46

Author(s):

Md Helal Uddin ◽

ATM Humayun Kabir ◽

Md Ismail Chowdhury ◽

Farzana Zafreen

Keyword(s):

Mechanical Ventilation ◽

Electrophysiological Study ◽

Laboratory Data ◽

Guillain Barre Syndrome ◽

Military Hospital ◽

Upper Respiratory Tract ◽

Intravenous Immunoglobulin Therapy ◽

Number Of Patients ◽

Guillain Barré Syndrome ◽

Guillain Barré

Introduction: Guillain-Barre Syndrome (GBS) is an acute, frequently severe and fulminant polyradiculopathy that is autoimmune in nature and that causes acute neuromascular failure. The condition is quite common in Bangladesh. GBS is an autoimmune and post-infectious immune disease. Objectives: To see the different presentation and outcome of GBS in combined military hospital (CMH) Dhaka. Materials and Methods: This was a retrospective observational study conducted on all the GBS patients admitted in the Neurology Ward of CMH Dhaka from January 2005 to July 2010. Total 25 patients clinical and laboratory data including CSF analysis, electrophysiological study data were collected from patients’ case sheet. Results: Among the 25 GBS patients male was 22 (88%) and female 03(12%) and most common age group affected was 31-40 years comprising of 09(36%) patients. The most common types of GBS patients were acute inflammatory demyelinating polyneuropathy (AIDP) 17(68%) patients and 10(40%) patients were found to have history of upper respiratory tract infection (URTI). Albuminocytological dissociation was found in 20(80%) patients in CSF study. Intravenous immunoglobulin therapy was given to 13(52%) patients, of them 09(36%) patient needed mechanical ventilation; rest 12(48%) patients were treated conservatively. The final outcome was full recovery 22(88%) patients, 02(8%) patients had residual disability and only one patient died after 2 years of GBS. Conclusion: GBS is an important cause of peripheral neuropathy. Patient should be monitored carefully because a significant number of patients ultimately require mechanical ventilation for respiratory failure which may be of sudden onset. JAFMC Bangladesh. Vol 16, No 2 (December) 2020: 44-46

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Prediction of Functional Outcome in Axonal Guillain-Barre Syndrome

Annals of Rehabilitation Medicine ◽

10.5535/arm.2016.40.3.481 ◽

2016 ◽

Vol 40 (3) ◽

pp. 481 ◽

Cited By ~ 2

Author(s):

Eun Jung Sung ◽

Dae Yul Kim ◽

Min Cheol Chang ◽

Eun Jae Ko

Keyword(s):

Functional Outcome ◽

Guillain Barre Syndrome ◽

Guillain Barré Syndrome ◽

Guillain Barré

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A simple functional marker to predict the need for prolonged mechanical ventilation in patients with Guillain-Barré syndrome

Critical Care ◽

10.1186/cc10043 ◽

2011 ◽

Vol 15 (1) ◽

pp. R65 ◽

Cited By ~ 26

Author(s):

François Fourrier ◽

Laurent Robriquet ◽

Jean-François Hurtevent ◽

Shirley Spagnolo

Keyword(s):

Mechanical Ventilation ◽

Prolonged Mechanical Ventilation ◽

Functional Marker ◽

Guillain Barre Syndrome ◽

Guillain Barré Syndrome ◽

Guillain Barré

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Original research: Second IVIg course in Guillain-Barré syndrome with poor prognosis: the non-randomised ISID study

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2019-321496 ◽

2019 ◽

Vol 91 (2) ◽

pp. 113-121 ◽

Cited By ~ 7

Author(s):

Christine Verboon ◽

Bianca van den Berg ◽

David R Cornblath ◽

Esmee Venema ◽

Kenneth C Gorson ◽

...

Keyword(s):

Poor Prognosis ◽

Randomised Trial ◽

Guillain Barre Syndrome ◽

Original Research ◽

Disability Score ◽

Prospective Randomised Trial ◽

Guillain Barré Syndrome ◽

Secondary Endpoints ◽

The One ◽

Guillain Barré

ObjectiveTo compare disease course in patients with Guillain-Barré syndrome (GBS) with a poor prognosis who were treated with one or with two intravenous immunoglobulin (IVIg) courses.MethodsFrom the International GBS Outcome Study, we selected patients whose modified Erasmus GBS Outcome Score at week 1 predicted a poor prognosis. We compared those treated with one IVIg course to those treated with two IVIg courses. The primary endpoint, the GBS disability scale at 4 weeks, was assessed with multivariable ordinal regression.ResultsOf 237 eligible patients, 199 patients received a single IVIg course. Twenty patients received an ‘early’ second IVIg course (1–2 weeks after start of the first IVIg course) and 18 patients a ‘late’ second IVIg course (2–4 weeks after start of IVIg). At baseline and 1 week, those receiving two IVIg courses were more disabled than those receiving one course. Compared with the one course group, the adjusted OR for a better GBS disability score at 4 weeks was 0.70 (95%CI 0.16 to 3.04) for the early group and 0.66 (95%CI 0.18 to 2.50) for the late group. The secondary endpoints were not in favour of a second IVIg course.ConclusionsThis observational study did not show better outcomes after a second IVIg course in GBS with poor prognosis. The study was limited by small numbers and baseline imbalances. Lack of improvement was likely an incentive to start a second IVIg course. A prospective randomised trial is needed to evaluate whether a second IVIg course improves outcome in GBS.

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