Electrophysiological Pattern and Predictors of Functional Outcome of Patients with Guillain Barre Syndrome at a Tertiary Care Hospital in Pakistan.

OBJECTIVE

To determine electrophysiological pattern and predictors of functional outcomes of patients with Gullain Barre Syndrome (GBS) at a tertiary care hospital.

STUDY DESIGN

Observational study.

PLACE AND DURATION OF STUDY

Shifa International Hospital, Islamabad, Pakistan from January 2016 to July 2020.

METHODOLOGY

A total of 62 patients with GBS of all age groups, gender, locations and those with no other primary diagnosis such as poliomyelitis, botulism, hysterical paralysis, toxin neuropathy and diabetic neuropathy were included. Functional outcome using modified Rankin Scale (mRS) and HUGHES score were recorded at presentation, on discharge and 6-month follow-up. Results of this study were analyzed using SPSS version 20.

RESULTS

There were 69% males with mean age of 31 ± 21years. The frequency of different GBS variants were 53% acute inflammatory demyelinating polyneuropathy (AIDP), 29% acute motor axonal neuropathy (AMAN), 11% acute motor and sensory axonal neuropathy (AMSAN) and pure sensory and atypical GBS were 2% each. The frequency of various antecedent events was recorded in 33 patients, including respiratory tract infection in 9 (14%) and diarrhea/vomiting in 13 (21%) patients. AIDP and AMSAN had a good prognosis where 31 (77%) patients out of the 40 fully recovered with HUGHES score 0-2 after 6 months. AMAN had poor prognosis as 2 (12%) patients died in the Hospital. Majority (n=32, 52%) of the patients were treated with plasmapheresis.

CONCLUSION

In this study population, AIDP was the most common variant with good prognosis and AMAN variant had the worst prognosis. Key Words: Guillain Barre syndrome (GBS), Acute inflammatory demyelinating polyneuropathy (AIDP), Acute motor axonal neuropathy (AMAN), Peripheral neuropathy, Lower limb weakness, Acute motor and sensory axonal neuropathy (AMSAN), Sensory neuropathy, Autoimmune disease.