Instituto Nacional de Neurología y Neurocirugía Dr. Manuel Velasco Suárez, Ciudad de México, México.
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México.
Rev Neurol. 2022 Apr 16;74(8):258-264. doi: 10.33588/rn.7408.2021437.
As SARS-CoV-2 vaccination is ongoing in Mexico and Guillain-Barre syndrome (GBS) cases have been reported, validation of Brighton criteria in Mexico is necessary. Moreover, epidemiology of GBS in Mexico differs from European and North American countries.
To describe the clinical, cerebrospinal and electrodiagnostic features in Mexican patients diagnosed with GBS and classify them according to the Brighton Collaboration Group diagnostic criteria. Patrients and methods. An ambispective cohort study was conducted. We included patients that fulfilled the National Institute of Neurological Disorders and Stroke (NINDS) diagnostic criteria for Guillain-Barre syndrome. Patients in this study were classified according to Brighton collaboration group levels of certainty for Guillain-Barre syndrome.
Sixty eight percent of patients were male. Of the 248 patients included, 58.4% had history of a precedent infection, mean time from symptom onset to admission was 5 (1-30) days. Mean Medical Research Council sum score 30.3 ± 15.5. Almost 98% of patients had a monophasic course. Level 1 of certainty according to Brighton collaboration group criteria was fulfilled by 54.6% of patients, level 2 by 45% and level 4 by 0.6%. Patients meeting level 2 of certainty were mostly because normal cerebrospinal fluid findings or findings in nerve conduction studies not consistent with any GBS variants.
GBS is a frequent autoimmune neuropathy that has been associated with preceding infections and with vaccination campaigns. For SARS-CoV-2 vaccination campaign in Mexico, validation of Brighton Criteria is necessary. Although Mexico's GBS epidemiology has been changing throughout recent years, this study provides similar data compared to other countries.
由于墨西哥正在进行 SARS-CoV-2 疫苗接种，并且已经报告了格林-巴利综合征（GBS）病例，因此有必要在墨西哥验证 Brighton 标准。此外，墨西哥 GBS 的流行病学与欧洲和北美国家不同。
描述在墨西哥诊断为 GBS 的患者的临床、脑脊液和电诊断特征，并根据 Brighton 协作组诊断标准对其进行分类。
进行了一项前瞻性队列研究。我们纳入了符合国家神经疾病和中风研究所（NINDS）格林-巴利综合征诊断标准的患者。根据 Brighton 合作组对格林-巴利综合征的确定性水平对本研究中的患者进行分类。
68%的患者为男性。在 248 名患者中，58.4%有前驱感染史，从症状出现到入院的平均时间为 5 天（1-30 天）。平均医疗研究委员会总评分 30.3 ± 15.5。几乎 98%的患者有单相病程。根据 Brighton 合作组标准，有 54.6%的患者达到确定性水平 1，45%的患者达到确定性水平 2，0.6%的患者达到确定性水平 4。满足确定性水平 2 的患者主要是因为脑脊液正常或神经传导研究结果不符合任何 GBS 变异。
GBS 是一种常见的自身免疫性神经病，与前驱感染和疫苗接种活动有关。对于墨西哥的 SARS-CoV-2 疫苗接种活动，有必要验证 Brighton 标准。尽管近年来墨西哥的 GBS 流行病学一直在发生变化，但本研究提供的数据与其他国家相似。
