P-PN008. Electrophysiological subtypes of Guillain-Barré syndrome (GBS) cases at tertiary general hospital, Myanmar

Abstract

Introduction. Nerve conduction study (NCS) plays an important role in Guillain-Barre syndrome (GBS) diagnosis and subtypes classification. GBS subtypes were reported to vary with different geography. We aim to study the electrophysiological subtypes of GBS cases at the biggest tertiary general hospital, Myanmar. Methods. It was hospital-based prospective study at Neurology ward, Yangon General Hospital over 1.5-year period from June 2017 to January 2019. At least 2 nerve conduction studies (NCS) were done. Results. A total of 50 patients with GBS were recruited, with mean age 32.66 ± 17.93 years. Male-to-female ratio was 2.6:1. History of preceding illness was present in 58% (diarrhea in 8%, respiratory infection in 14% and unspecified fever in 13%). 32% had facial palsy, 36% bulbar, 8% ataxia, and 6% had ocular involvement. Various antiganglioside antibodies were detected in 44%. Good outcome was noted in 88% and poor outcome in 12%. 44% met criteria for acute inflammatory demyelinating polyneuropathy (AIDP) whereas 56% were found to have axonal type. Among axonal types, 40% were acute motor axonal neuropathy (AMAN) and 16% were acute motor and sensory axonal neuropathy (AMSAN). 77% of GBS post Mycoplasma infections were axonal subtypes. 57.1% of Campylobacter positive GBS were demyelinating and the rest axonal types. All CMV positive and those with positive influenza serology were electrophysiologically AMAN subtypes. Antiganglioside antibodies were positive in 27.3% of AIDP, 55% of AMAN, 75% of AMSAN. 27.3% of AIDP and 60.7% of axonal subtypes were associated with antiganglioside antibodies. Among poor outcome patients, AIDP was 83% and axonal 17%. Conclusion. The most common electrophysiological type among GBS patients in Myanmar was axonal (56%), and axonal type was associated with positive anti-ganglioside antibodies (P = 0.042). In contrast to other studies, our poor outcome patients were more of demyelinating type.