Guillain-barre syndrome : a clinical study

Abstract EN

Objectives : To study Guillain-Barre syndrome (GBS) in Baghdad.

Methods: In a cross-sectional, multi-center study, 50 Iraqi patients who were admitted to 5 neurological centers in Baghdad, Iraq between October 1998 and October 2000 and who were diagnosed by consultant neurologists as cases of GBS, were studied for various clinical, CSF, and neurophysiological factors.

Results: Male to female ratio was 3.1:1; the mean age was 21 years +/-16 (SD), and there was peaking in the 2nd decade of life.

The disease clustered in the winter season in 44% of cases.

Antecedent events were reported in 86%.

Muscle weakness alone was the initial symptom in 34% of the cases.

In 80%, the weakness started in the lower extremities.

Cranial nerves were involved in 68%, and sensory symptoms were noted in 66%.

There was autonomic involvement in 50%.

Assisted ventilation was required in 42% of patients, and there was a significant association between need for assisted ventilation and cranial nerve involvement.

The mortality was 16%, which had a significant correlation with age above 50 years and a highly significant correlation with the need for ventilatory support.

A demyelinating neuropathic picture was seen in 80% of patients in neurophysiological study.

The CSF protein was raised in 89.2% of the 37 patients in whom CSF was studied.

Conclusion : Sensory and motor manifestations usually occurred together.

Pure motor manifestations occurred, but pure sensory neuropathy was not encountered.

There was an obvious seasonal variation with the disease clustered mainly in the winter.

Cranial nerves were frequently involved and there was a highly significant correlation with the development of respiratory paralysis.

Respiratory paralsyis had a highly significant correlation with mortality.

All patients with GBS should be admitted to hospitals where specialized respiratory care is available.