Guillain-Barre syndrome in Sri Lanka: subtypes and trends

Abstract

Objectives: To evaluate Guillain-Barre syndrome (GBS) subtypes in Sri Lanka. Design setting: The patients satisfying established criteria for diagnosis of GBS were included. The cases were classified into GBS subtypes based on electrodiagnostic findings. Patient intervention: None Measurements: Clinical neurophysiological evaluations were done. The studies were repeated as appropriate. Results: The evaluations were done between 2 and 143 days from onset (median = 7 days). There were 1153 patients (Male: Female = 1.4 :1) with age 1 to 86 years (mean = 43.7). Of them 191 (16.6%) were below 13 years (Male: Female = 1.2:1). GBS subtypes were demyelinating type 577 (50%), axonal forms 475 (41.2%), Miller-Fisher syndrome 5 (0.4%) and unclassifiable 96 (8.3%). Among the children there were 99 (51.8%) with demyelinating type, 82 (42.9%) with axonal forms, 10 (5.2%) with unclassifiable findings and none with MFS. There was some clustering of both demyelinating and axonal cases in the early and late months of the year whereas in children there is excessive occurrence of GBS cases of both types in the first 5 months of the year. There is a second peak of axonal GBS later in the year. Overall tendency of reduction in the number of cases, especially axonal forms, is noticeable over the years. Interpretation: The age and sex distribution of the cases is similar to that of other countries. The occurrence of axonal subtypes is prominent. The proportions of GBS subtypes and case clustering in children may be related to the preceding infection.