CLINICAL PROFILE OF GUILLAIN BARRE SYNDROME FROM A TERTIARY CARE CENTRE.

Dr.S. Sreevani; M. Bhargavi; Dr.K.S. Amaravathi; Dr.P.  Sakunthala

Volume : VI, Issue : VIII, August - 2016

CLINICAL PROFILE OF GUILLAIN BARRE SYNDROME FROM A TERTIARY CARE CENTRE.

Dr. S. Sreevani, M. Bhargavi, Dr. K. S. Amaravathi, Dr. P. Sakunthala

Abstract :

OBJECTIVES: To study clinical presentation, pattern of nerve conduction studies(NCS), treatment modalities and outcome of patients with Guillain Barre Syndrome (GBS) from a tertiary care centre at Hyderabad. MATERIAL AND METHODS: 70 patients of GBS studied in detail including history, clinical examination and investigations. All patients were watched for respiratory insufficiency and those who developed respiratory paralysis were given assisted mechanical ventilation. Patients were treated with IV Methyl prednisolone, IV Ig and plasmapharesis depending on patient condition and outcome was observed. Pattern of NCS in all patients at admission and outcome was studied. RESULTS: Patients age group affected was 16–70 yrs. The male: female ratio was 1.9: 1. Antecedent infection in the form of fever(24patients), loose motions(8 patients) were present in 32(45%) out of 70 patients. Quadriparesis was present in 52(74%) patients and paraparesis in 18(25%) patients. Areflexia was found in 69(98.5%) patients. NCS showed acute motor and sensory axonal neuropathy (AMSAN) in 52(74%) patients, acute motor axonal neuropathy(AMAN) in 6(8.5%) patients, acute inflammatory demyelinating polyradiculoneuropathy (AIDP) in 8(11.4%) and secondary axonal in 4(5.7%) patients. Out of 70 patients 3 (4.2%) patients were treated with IV Ig, 5(7.1%) patients with plasmapheresis. IV steroids and supportive treatment given in 62(88.5%) patients. 3(4.2%) patients required mechanical ventilation, one patient died and 68(97%) were recovered, one patient with respiratory failure discharged against medical advice. CONCLUSION: GBS is more common in 21–40 yrs age group, with male: female ratio of 2.1:1. Antecedent infection is seen in 45% patients. Commonest presentation was quadriparesis (74%). Only 3 patients developed respiratory paralysis and needed ventilatory support and 1 patient expired and 68 patients recovered.