Abstract

The proportion of different subtypes of Guillain-Barré syndrome (GBS) and their prognosis varied significantly among different regions. This study attempts to investigate the clinical subtypes and outcome of GBS in southwest China. Patients with GBS admitted to The First Affiliated Hospital of Chongqing Medical University from January 2006 to March 2013 were included in our study. Patients were classified into acute inflammatory demyelinating polyneuropathy (AIDP) group, acute motor axonal neuropathy (AMAN) group, Miller-Fisher syndrome (MFS) group, cranial nerve variants(CNV), Bickerstaff's brainstem encephalitis overlaps with GBS (BBE-GBS) group and unclassifiable group based on clinical features and electrophysiological findings. Hughes function grade score (HFGS) was used to assess the prognosis at 3 and 6 months. The prognosis of different subtypes and outcome predictors were analyzed. The most common subtype of GBS was AIDP (57%), followed by AMAN (22%) and MFS (7%). The prognosis of AMAN and BBE-GBS is similar at 3 month(P = 0.0704)and 6 month (P = 0.1614) follow-up. The prognosis of AMAN group was poorer than that of AIDP group at 3 month and 6 month follow-up (P<0.001). Outcome of MFS group and that of CNV group at 6 months were both good(Hughes≤1). Hughes≥3(P<0.0001,OR = 6.650,95%CI = 2.865 to 15.023))and dysautonomia (P = 0.043,OR = 2.820,95%CI = 1.031 to 7.715)) were associated with poor outcome at 6 month follow-up. AIDP is the most common subtype of GBS. Prognosis of AMAN group and BBE-GBS group is poorer than that of AIDP group at 3 month and 6 month follow-up. Hughes≥3 at nadir and dysautonomia are predictors of poor prognosis at 6 month follow-up.

Highlights

  • Guillain–Barré syndrome (GBS) is a common neurological disorder that is characterized by symmetrical weakness of the limbs, which reaches a maximum severity within 4 weeks [1,2]

  • Previous reports from western countries showed that acute inflammatory demyelinating polyneuropathy (AIDP) is the most common subtype of GBS [14,15], while reports from northern China showed that acute motor axonal neuropathy (AMAN) is the most common subtype of GBS in China [16].The proportion of different subtypes of GBS and their prognosis varied significantly among different regions [17,18,19,20,21]

  • The patients were classified into the following five categories as follows: acute inflammatory demyelinating polyneuropathy (AIDP) group, acute motor axonal neuropathy (AMAN) group, Miller-Fisher syndrome (MFS) group, cranial nerve variant (CNV), Bickerstaff's brainstem encephalitis overlaps with or without Guillain-Barre syndrome (BBE-GBS) and the unclassified group based on clinical features and electrophysiological findings

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Summary

Introduction

Guillain–Barré syndrome (GBS) is a common neurological disorder that is characterized by symmetrical weakness of the limbs, which reaches a maximum severity within 4 weeks [1,2]. Intravenous immunoglobulin (IVIG) and plasma exchange (PE) were proven to be effective treatment options for GBS [3,4,5], many patients still have poor prognosis and sequelae such as decreased mobility, severe long-term fatigue syndrome and chronic pain.[6] The reported mortality of GBS varies between 3% and 7%[7,8,9]. Guillain-Barré Syndrome in Southwest China predominantly motor neuropathy involving distal limb paresthesias, relatively symmetric leg weakness, and frequent hyporeflexia or areflexia. Previous reports from western countries showed that acute inflammatory demyelinating polyneuropathy (AIDP) is the most common subtype of GBS [14,15], while reports from northern China showed that acute motor axonal neuropathy (AMAN) is the most common subtype of GBS in China [16].The proportion of different subtypes of GBS and their prognosis varied significantly among different regions [17,18,19,20,21]

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