F30. Axonal variants of Guillain Barre Syndrome are predominant among nepalese population: A tertiary care center study

Abstract

Introduction Guillain Barre Syndrome (GBS) is an acute, frequently severe, and fulminant polyradiculoneuropathy that is autoimmune in nature. Our aim is to classify GBS subtypes and evaluate the clinical severity. Methods All consecutive patients recruited prospectively in the study were of age ⩾ 16 years and were being admitted in department of Neurology of Tribhuvan University Teaching Hospital, Kathmandu, Nepal from 2016 March to 2017 February. All demographic, historical and clinical data were collected. Nerve conduction study, cerebrospinal fluid analysis along with clinical features were evaluated to assess the diagnostic certainty of Brighton Criteria. Overall disability sum score and GBS disability score were assessed in all patients. Results A total of 46 patients were included: male patients being predominant (70% vs 30%), mean age = 36.5 ± 16.2, range = 16–80 years. Thirty-two patients (70%) were axonal variant, acute motor axonal neuropathy being more common (18 patients), and 14 patients were acute motor and sensory axonal neuropathy. 14 patients (30%) were demyelinating type, out of which 11 patients had both motor and sensory features, and only 3 patients were pure motor demyelinating type. Axonal variants were found to have higher Overall disability sum score during nadir (p = 0.024) and discharge (p = 0.004), and also higher GBS disability score during nadir (p = 0.012) and discharge (p = 0.021). Acute motor axonal neuropathy (AMAN) had higher GBS disability score than acute inflammatory demyelinating polyneuropathy (AIDP) at nadir (p = 0.034) and discharge (p = 0.039). Conclusion AMAN subtype are predominant among Nepalese population. Axonal variants of GBS are clinically severe than demyelinating variants.