Disease and Patient Characteristics Contributing to Diagnostic Delays in Patients With Guillain-Barré Syndrome.

Chakrapani Pathikonda,Nakul Katyal,Naureen Narula,Raghav Govindarajan

doi:10.3389/fneur.2021.684847

Chakrapani Pathikonda, Nakul Katyal + Show 2 more

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https://doi.org/10.3389/fneur.2021.684847

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Abstract

Introduction: Diagnosis of Guillain Barre syndrome (GBS) is often made clinically. Certain patient and disease characteristics can cause delays in diagnosis and management.Methods: Observational retrospective study of forty-four patients diagnosed with GBS either clinically, cerebrospinal fluid analysis, and/or by electro-diagnostic criteria at a teaching hospital (University of Missouri Hospital) in Columbia, Mid-Missouri between 2011 and 2017.Results: Patients with coexisting neurological conditions had statistically significant delay in diagnosis of GBS [Mean (SD); 13 ± 5 vs. 9.39 ± 4.7; p = 0.03]. Patients presenting with motor + symptoms (sensory and/or autonomic, in addition to motor), compared to those with only motor symptoms had statistically significant delay in diagnosis of GBS [Mean (SD); 11.90 ± 5 vs. 8.58 ± 4; p = 0.04].Discussion: Presence of co-existing neurological conditions, and motor + symptoms can delay timely diagnosis and management of GBS.

Highlights

Diagnosis of Guillain Barre syndrome (GBS) is often made clinically
Patients presenting with motor + symptoms, compared to those with only motor symptoms had statistically significant delay in diagnosis of GBS [Mean (SD); 11.90 ± 5 vs. 8.58 ± 4; p = 0.04]
We retrospectively reviewed data of 44 patients diagnosed with GBS between 2011 and 2017 at a teaching hospital and analyzed patient and disease characteristics contributing to delay in diagnosis of GBS

Summary

Introduction

Diagnosis of Guillain Barre syndrome (GBS) is often made clinically. Certain patient and disease characteristics can cause delays in diagnosis and management. Guillain-Barre Syndrome (GBS) is a heterogenous group of immune-mediated peripheral neuropathies with demyelinating and acute axonal degenerating pathologies [1]. The diagnosis of GBS is often made clinically as sensitivities of objective findings in electrodiagnostic study and cerebrospinal fluid (CSF) analysis are low in the first 1–2 weeks of disease onset [2]. GBS has a mortality rate of 3–13% prompt diagnosis and treatment is paramount [3, 4]. First-contact physicians must pay close attention to the presenting clinical symptoms and temporality of symptom onset to consider GBS as a differential and ensure prompt diagnosis

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