Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University Hospital, Assiut, Egypt.
Sci Rep. 2023 Aug 26;13(1):14000. doi: 10.1038/s41598-023-41072-x.
This study compared the clinical outcomes of the two main neurophysiological types of Guillain-Barré Syndrome (GBS). Sixty-two GBS patients were examined clinically at onset using Medical Research Council (MRC), Hughes disability scales (HDS), and nerve conduction studies were evaluated in four limbs. The Modified Erasmus GBS outcome score (MEGOS) was assessed 2 weeks after onset. Outcomes were measured after 3 months using MRC and HDS scores. According to electrophysiological data two main groups identified acute inflammatory demyelinating polyneuropathy (AIDP = 31 cases) or acute axonal GBS including inexcitable forms (26 cases). The number of days between onset of weakness and admission was significantly shorter, and gastrointestinal symptoms were significantly higher among the axonal type than AIDP. MRC sum scores at onset and at nadir were significantly worse in the axonal type than in AIDP. Neck muscle weakness, impaired cough reflex, the need for mechanical ventilation, hypoalbuminemia, and hypernatremia were more common in the axonal type. At outcome, 74% of the AIDP were healthy/minor symptoms versus 38.46% of the axonal type. There was a high prevalence of the axonal variant (41.9%) compared with European and North American populations. The axonal type had a significantly worse outcome than AIDP type.
这项研究比较了两种主要的吉兰-巴雷综合征（GBS）神经生理类型的临床结果。62 例 GBS 患者在发病时接受了医学研究委员会（MRC）、休斯残疾量表（HDS）的临床检查，并对四肢进行了神经传导研究评估。在发病后 2 周评估改良 Erasmus GBS 结局评分（MEGOS）。在发病后 3 个月使用 MRC 和 HDS 评分评估结果。根据电生理数据，确定了两个主要的组，即急性炎症性脱髓鞘性多发性神经病（AIDP=31 例）或急性轴索性 GBS，包括不可兴奋形式（26 例）。与 AIDP 相比，轴索性的无力起病至住院的天数明显缩短，胃肠道症状明显更高。轴索性的发病时和最低点时的 MRC 总分明显差于 AIDP。颈肌无力、咳嗽反射受损、需要机械通气、低白蛋白血症和高钠血症在轴索性中更为常见。在结局时，74%的 AIDP 为无症状/轻微症状，而轴索性的为 38.46%。与欧洲和北美人群相比，轴索性变体的患病率较高（41.9%）。轴索性的结局明显差于 AIDP 型。
