Abstract
Guillain-Barre syndrome is an acute immune-mediated polyneuropathy characterized by rapidly evolving symptoms and disability. Cerebrospinal fluid analysis and electrophysiological studies are crucial in the diagnosis of this syndrome. To evaluate the prognostic value of the type and number of demyelinating findings and cerebrospinal fluid protein levels in patients with acute inflammatory demyelinating polyneuropathy. We retrospectively analyzed electrophysiological data and cerebrospinal fluid of 67 consecutive patients with acute inflammatory demyelinating polyneuropathy from Istanbul, Turkey (2011-2019) studied ≤ 24 hours post-onset. The patients who met a higher number of demyelinating criteria had increased disability scores in the first day and first month, and higher cerebrospinal fluid protein levels were correlated with worse prognosis both on the first day and the first month. However, the disability scores did not correlate with any single specific criterion, and no significant correlation was found between the number of satisfied criteria and cerebrospinal fluid protein levels. The number of demyelinating criteria that are met and high cerebrospinal fluid protein levels at the disease onset may be valuable prognostic markers. More systematic studies conducted with serial nerve conduction studies are required to highlight the roles of the suggested criteria in clinical practice.
Highlights
Guillain-Barre syndrome (GBS) is an acute immunemediated polyneuropathy characterized by rapidly evolving symptoms, which are usually ascending symmetrical weakness or paralysis, and areflexia or hyporeflexia
Sixty‐two patients were treated with intravenous immunoglobulin (IVIg), and due to its ineffectiveness, plasma exchange was applied to five patients after IVIg
We examined the role of the type and number of demyelinating electrophysiologic findings and Cerebrospinal fluid (CSF) protein levels as prognostic markers of outcome in acute inflammatory demyelinating polyneuropathy (AIDP) patients
Summary
Guillain-Barre syndrome (GBS) is an acute immunemediated polyneuropathy characterized by rapidly evolving symptoms, which are usually ascending symmetrical weakness or paralysis, and areflexia or hyporeflexia. The symptoms reach their maximum severity up to four weeks[1,2]. Methods: We retrospectively analyzed electrophysiological data and cerebrospinal fluid of 67 consecutive patients with acute inflammatory demyelinating polyneuropathy from Istanbul, Turkey (2011-2019) studied ≤ 24 hours post-onset. Results: The patients who met a higher number of demyelinating criteria had increased disability scores in the first day and first month, and higher cerebrospinal fluid protein levels were correlated with worse prognosis both on the first day and the first month. More systematic studies conducted with serial nerve conduction studies are required to highlight the roles of the suggested criteria in clinical practice
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