Department of Neurology, King George's Medical University, Lucknow, UP 226003, India.
J Neurol Sci. 2013 Dec 15;335(1-2):105-11. doi: 10.1016/j.jns.2013.09.002. Epub 2013 Sep 10.
Guillain-Barre syndrome (GBS) is an acute polyradiculoneuropathy with varied severity of presentation.
To study the clinical and electrophysiological profile of patients with GBS and to determine the factors associated with poor functional outcome and need for mechanical ventilation.
It was a hospital-based prospective observational study.
90 patients with GBS diagnosed as per Asbury and Cornblath criteria were enrolled and followed up for 6 months. Various epidemiological, clinical and electrophysiological parameters were evaluated. Hughes motor scale was used to measure functional outcome. Factors associated with poor functional outcome and need for mechanical ventilation were determined.
90 patients (56 males; 34 females; mean age of 29.3±15.2 years) were enrolled in this study. Amongst these 6 (6.7%) patients died during in-hospital stay. Antecedent infection was present in 29 (32.2%), autonomic dysfunction in 31 (34.4%), bulbar palsy in 21 (23.3%), neck flexor weakness in 52 (57.8%). 60 cases (66.7%) were of axonal variety and 30 (33.3%) of demyelinating variety. On univariate analysis, predictors associated with poor functional outcome at 6 months were autonomic dysfunction (p=0.013), neck flexor weakness (p=0.009), requirement of ventilatory assistance (p=<0.001), MRC sum score<30 on admission (p=<0.001) and axonal pattern on electrophysiological assessment (p=<0.001). On multivariate analysis, MRC sum score<30 on admission (p=0.007) and axonal pattern on electrophysiological assessment (p=<0.001) were independently associated with poor functional outcome at 6 months. Factors associated with need for mechanical ventilation were presence of autonomic dysfunction (p=<0.001), cranial nerve palsy including facial palsy (p=<0.001) and bulbar palsy (p=0.002), neck flexor weakness (p=<0.001), low MRC sum score (<30) (p=0.001), and low proximal CPN CMAP amplitude to distal CPN CMAP amplitude ratio (p=0.042); none of them being significant on multivariate analysis.
Detailed evaluation of the clinical and electrophysiological profile may help in predicting the functional outcome and need for mechanical ventilation in patients with GBS.
吉兰-巴雷综合征（GBS）是一种急性多发性神经根神经病，表现程度不一。
研究吉兰-巴雷综合征患者的临床和电生理特征，并确定与不良功能结局和需要机械通气相关的因素。
这是一项基于医院的前瞻性观察研究。
90 名符合 Asbury 和 Cornblath 标准的 GBS 患者被纳入研究并随访 6 个月。评估了各种流行病学、临床和电生理参数。使用 Hughes 运动量表测量功能结局。确定与不良功能结局和需要机械通气相关的因素。
本研究纳入了 90 名患者（56 名男性；34 名女性；平均年龄 29.3±15.2 岁）。其中 6 名（6.7%）患者在住院期间死亡。29 名（32.2%）患者存在前驱感染，31 名（34.4%）患者存在自主神经功能障碍，21 名（23.3%）患者存在球麻痹，52 名（57.8%）患者存在颈屈肌无力。60 例（66.7%）为轴索性，30 例（33.3%）为脱髓鞘性。单因素分析显示，6 个月时功能结局不良的预测因素包括自主神经功能障碍（p=0.013）、颈屈肌无力（p=0.009）、需要通气支持（p<0.001）、入院时 MRC 总评分<30（p<0.001）和电生理评估中的轴索性模式（p<0.001）。多因素分析显示，入院时 MRC 总评分<30（p=0.007）和电生理评估中的轴索性模式（p<0.001）是 6 个月时功能结局不良的独立预测因素。需要机械通气的相关因素包括自主神经功能障碍（p<0.001）、颅神经麻痹包括面瘫（p<0.001）和球麻痹（p=0.002）、颈屈肌无力（p<0.001）、MRC 总评分低（<30）（p=0.001）和近端 CPN CMAP 振幅与远端 CPN CMAP 振幅比值低（p=0.042）；但这些因素在多因素分析中均不显著。
详细评估临床和电生理特征有助于预测吉兰-巴雷综合征患者的功能结局和需要机械通气的情况。
