Guillain‐Barré syndrome (GBS) in a tertiary general hospital at Yangon, Myanmar

Abstract

AbstractAimThe aim of the study was to study the profile of Guillain‐Barré syndrome (GBS) patients admitted at Yangon General Hospital (YGH), Myanmar.MethodsPatients with flaccid quadriparesis due to GBS admitted to the Department of Neurology, YGH in 2019 were prospectively studied.ResultsNinety‐four GBS patients were recruited. Mean age was 36.2 years. Male to female ratio was 2.4:1. Patients were admitted 12.1 ± 14.8 days after disease onset. 46.8% were from outside the Yangon region. Peak incidence was in rainy season (47.9%). 62.8% reported symptoms suggestive of preceding infection: 45.7% unspecified fever, 3.2% upper respiratory infection, 8.5% diarrhea, and 5.3% fever with rash. 27.7% had bulbar and 44.7% had facial weakness. 5.3% had GBS/Miller Fisher syndrome overlap. Electrophysiologically, 50% were acute inflammatory demyelinating polyneuropathy (AIDP), 30% acute motor axonal neuropathy (AMAN), and 20% acute motor‐sensory axonal neuropathy (AMSAN). Maximum disability was reached at 5.6 ± 4.78 days from onset. The plateau phase lasted 12.12 ± 14.27 days. 13.8% required ventilator support. 64.9% of patients received limited manual plasma exchange, 9.6% standard plasma exchange, 4.3% intravenous immunoglobulin and 21.3% no specific treatment. 79.8% had good clinical recovery at 4 weeks from inclusion. Mortality was 0%. Severity at admission was identified as the only poor recovery predictor.ConclusionGuillain‐Barré syndrome in a Yangon tertiary hospital peaked in rainy season and axonal GBS accounted for 50% cases. However, diarrhea was an uncommon antecedent. The good recovery was noted in 79.8% and largely predicted by severity of disease at admission.