Outcome In Guillain-Barre Syndrome Research Articles

Correlation of Cerebrospinal Fluid Total Protein and Serum Neutrophil-to-Lymphocyte Ratio with Clinical Outcomes of Guillain-Barre Syndrome Variants.

To evaluate the correlation of cerebrospinal fluid total protein and serum neutrophil-to-lymphocyte ratio with the clinical outcomes and the various clinical and electrophysiological variants of Guillain-Barre syndrome. Cross-sectional study. Place and Duration of the Study: Department of Neurology, Mayo Hospital and King Edward Medical University, Lahore, Pakistan, from November 2022 to April 2023. Fourty-six Guillain-Barre syndrome patients, aged 12-70 years, were included in the study diagnosed by using the Brighton's criteria. Functional disability and respiratory insufficiency were assessed by using the modified Hughes disability score and the Erasmus Guillain-Barre syndrome respiratory insufficiency score, respectively.Serum neutrophil-to-lymphocyte ratio and cerebrospinal fluid total protein were calculated for each patient at the time of admission. Axonal variants had a higher mean neutrophil-to-lymphocyte ratio (5.29 ± 4.38) than demyelinating variants (4.71 ± 3.4) and Miller-Fischer syndrome (3 ± 2.828). This ratio was positively correlated with the modified Hughes's disability score (r = 0.790, p = 0.001) and the Erasmus Guillain-Barre syndrome respiratory insufficiency score (r = 0.936, p = 0.002). Mean cerebrospinal fluid total protein was higher for demyelinating (218 ± 136 mg/dl) than axonal variants (86 ± 56 mg/dl) and Miller-Fischer syndrome (34 ± 21 mg/dl). However, higher modified Hughes disability score (4-6) (r = 0.020, p = 0.117) and a high Erasmus Guillain-Barre syndrome respiratory insufficiency score (5-7) (r = 0.115, p = 0.302) did not significantly affect mean cerebrospinal fluid total proteins. Serum neutrophil-to-lymphocyte ratio can be regarded as a reliable biomarker to assess disease severity and clinical outcome in Guillain-Barre syndrome. Cerebrospinal fluid total protein is a poor predictor of the prognosis and severity of Guillain-Barre syndrome. Guillain-Barre syndrome (GBS), Clinical outcome, Cerebrospinal fluid total protein (CSF-TP), Neutrophil-to-lymphocytic ratio (NLR), Prognostic biomarker.

Utility of cerebrospinal fluid protein biomarkers in predicting the outcome of Guillain-Barre syndrome

Objectives The study aimed to investigate the potential of peripheral myelin protein 2 (P2) and Alpha B-crystallin (αBC) as predictive biomarkers in Guillain-Barré syndrome (GBS). Given the unpredictability of GBS prognosis, the need for specific and reliable biomarkers for disease development and intensity assessment is crucial. Material and Methods A prospective observational study was conducted on a cohort of 220 individuals diagnosed with GBS at a tertiary general hospital in South India. P2 and αBC levels in cerebrospinal fluid (CSF) were quantified using ELISA assay kits. The study spanned from March 2021 to April 2023, with participants aged 18–60 years. The study protocol adhered to ethical standards, and the Brighton criteria were employed for GBS diagnosis. CSF samples were collected at admission and two weeks post-onset. Data analysis utilised SPSS, and statistical significance was set at p < 0.05. Results Upon admission, mean P2 levels were 2.2 ± 0.5 ng/mL, and αBC levels were 9.8 ± 2.3 ng/mL. After two weeks, P2 increased to 4.8 ± 0.8 ng/mL, and αBC increased to 15.1 ± 2.3 ng/mL. A positive correlation was observed between the rise in P2 and αBC levels and enhanced muscle strength at 4 weeks and 6 months. Conclusion The study suggests a significant increase in P2 and αBC levels in GBS patients, correlating with improved muscle strength. P2 and αBC ratios in CSF between the second and first weeks may serve as prognostic markers for GBS. Limitations include a small sample size and the absence of a control group, necessitating caution in generalizability.

CLINICO- ELECTROPHYSIOLOGICAL AND CSF PROFILE AND PREDICTORS OF FUNCTIONAL OUTCOME IN GUILLAINE-BARRE SYNDROME- A PROSPECTIVE STUDY

BACKGROUND Guillain-Barre syndrome (GBS) is a rare, immune mediated disorder which is associated with demyelination of peripheral nervous system and progressive muscle weakness, with an annual global incidence of approximately 1–2 per 100,000 person-years. GBS has an unpredictable clinical course with up to 30% of patients requiring assisted ventilation during the course of their illness. Recent advances in the eld of critical care has successfully improved the outcome of GBS. Successful management mandates anticipation, prompt recognition of modiable risk factors and optimal treatment of neuromuscular respiratory failure in GBS. There is limited Indian data with regards to the early determinants and outcome of severely affected GBS patients. Knowledge of early predictors can substantially improve patient care and provides essential data for triage at an early stage in the course of the illness. OBJECTIVE 1. To study the clinical, electrophysiological prole, progression and outcome of GBS in a tertiary care hospital. 2. To determine the factors associated with the poor functional outcome, including the need for mechanical ventilation. MATERIALS AND METHODS This was a single centre, prospective study with 50 patients with GB syndrome, conducted from from 1st June 2021 to 30th May 2022 for a period of 1 year at Gauhati Medical College and Hospital. Their clinical, electrophysiological, CSF parameters were analysed. Hughes grading, EGRIS, mEGOS, MRC sum score were used. Any clinical deterioration and need for mechanical ventilation were noted carefully. Patients were followed up at 3 months and 6 months at assess their outcome. The mean age of the patients was 30.5 RESULTS years with a male female ratio of 1.3:1. AIDP was the most prevalent subtype found in 23(46%) patients followed by AMAN in 14(28%), AMSAN in 9(18%) and 4(8%) cases were unclassied. 32(64%) had severe disease with Hughes score ≥ 4 and 28(56%) had MRC score <40 at presentation. Respiratory distress was found in 17(34%) of patients, and out of which 10(20%) required mechanical ventilation. During the study 2(4%) patients died of complications. At 3 months, 30(60%) patients had complete recovery, 12(24%) had partial recovery and 6(12%) had poor recovery. At 6 months, 35(70%) had good recovery, 9(18%) had partial recovery and 4(8%) had poor recovery. Delayed CONCLUSION presentation, early peak of illness, prolonged Hospital stay, bulbar weakness, neck exor weakness, bilateral facial weakness, quadriparesis, respiratory distress, need for mechanical ventilation, autonomic dysfunction; high Hughes grading, low average single breath count along with high EGRIS, mEGOS, MRC sum score, high CSF protein, albumin-cytological dissociation, presence of F-wave abnormalities and Non stimulable nerves or Inexcitable nerves on NCS, AMAN subtype and systemic complications are associated with poor outcome. The overall outcome of GBS is favourable.

Clinical profile and outcome of Guillain Barre syndrome in a tertiary care hospital

Background: Guillain Barre syndrome (GBS) is a progressive symmetric muscular weakness with absent or depressed deep tendon reflexes. Wide spectrum of disease severity can be seen ranging from a mild disease to quadriparesis, cranial nerve involvement and autonomic instability. Methods: Hospital based observational study is planned for GBS patients admitted to Cheluvamba hospital, a tertiary care hospital in South India, for a period of 2.5 years from Jan 2020 to August 2022.Results: 30 patients (12 males; 18 females; mean age of 7.7 years) were enrolled in this study. Among which 11 were in age group of 0-5 (36%), 10 were in the age group of 6-10 (33%), 7 were in age group of 10-15 (23%), 2 were in age group 16 and above (6.6%). Type of paralysis was paraparesis in 14 (46%) children quadriparesis in 15 (50%) children and one child had no limb involvement. In associated dysfunctions, autonomic dysfunction was seen in 1 (4.5%), bulbar palsy in 3 (13.6%). One child presented with features of Miller Fischer variant of GBS which are ophthalmoplegia and ataxia. Among 30 children 22 were recovered and discharged, 3 children died, and 5 children left against medical advice.Conclusions: The clinical characteristics, subtype of GBS, and outcome vary according to geographic area. This study is directed to find the clinical pattern and outcome of the same in tertiary care hospital in south India.

Identification of factors affecting outcomes in patients with Guillain Barre syndrome.

Guillain Barre syndrome (GBS) is a rare autoimmune neurological disorder resulting in variable clinical course and outcome. Various factors such as age, symptoms and disease form that influence the outcome of GBS have been previously studied. This study aimed at identifying factors affecting the outcomes in patients with GBS. A retrospective observational study was conducted on GBS (ICD-G61.0) patients admitted to the hospital between 2014 and 2019. Patient information on demographics, medical and medication history, laboratory parameters, electrophysiological data, type of GBS and therapy received were retrieved from medical records. Univariate and multivariate analysis were conducted to identify factors associated with outcome (improved and not improved) and calculate odds ratio (OR). A total of 212 GBS patients were included in the study, of which 67% were males and the mean age was 39.9±20.1 years. 168 (79%) patients showed improvement whereas the remaining 44(21%) did not show improvement. Patients with hypertension (OR=4.512; CI=1.309-15.556, p=0.017), alcoholics (OR=5.148; CI=1.234-21.472, p=0.025), sepsis (OR= 9.139; CI=1.102-75.760, p=0.040) and cardiac arrest (OR=17.495; CI=1.249-245.027, p=0.034) were associated with risk of no improvement. Whereas those treated with IVIgG plus Physiotherapy/Occupational therapy (OR=0.062; CI=0.016-0.242, p=0.001) and Plasmapheresis plus Physiotherapy/Occupational therapy (OR=0.007; CI=0.000-0.147, p=0.001) were associated with improvement. Understanding these factors help to further give a more directed and focused management to improve the condition in patients who are at risk of poor outcome. Further follow-up studies could be done to determine and manage the residual disabilities associated with GBS to improve patient's quality of life.

Guillain barre syndrome and its association with covid-19 infection – A clinical case series

A novel coronavirus (COVID-19) pandemic is caused by severe acute respiratory syndrome coronavirus 2 (SARs-CoV-2). This pandemic has been globally alarming in the current period. Several neurological manifestations are reported occurring with the infection. Guillain barre syndrome (GBS) or acute onset inflammatory polyradiculoneuropathy has been among the frequent manifestations observed among them. To know the pattern and outcome of GBS in COVID-19 affected individuals. We have taken six individuals admitted with flaccid quadriparesis in the last two months. All were affected recently by COVID 19 infection, which RT PCR of the nasopharyngeal swab confirmed. The study participants have undergone nerve conduction studies and have been diagnosed with Guillain Barre syndrome using Brighton criteria. We did cerebrospinal fluid (CSF) analysis after admission. We initiated all patients on Intravenous immunoglobulin according to body weight (2g/kg divided over five days). We used the Barthel index score to assess the outcome of the individuals. We observed a mean duration of 18.25 days between the COVID-19 infection and the onset of symptoms. Apart from motor quadriparesis and sensory symptoms being in common, we also noticed cranial nerves and autonomic involvement. We made the diagnosis using the nerve conduction studies and Brighton criteria. After initiating intravenous immunoglobulin, all patients had a good outcome, and quality of life was better after two months of follow up. Guillain Barre syndrome is one of the neurological manifestations of COVID-19 and has a dramatic response with intravenous immunoglobulin and better outcome with treatment.

Study on Guillain-Barré Syndrome in A Tertiary Level Military Hospital

Introduction: Guillain-Barre Syndrome (GBS) is an acute, frequently severe and fulminant polyradiculopathy that is autoimmune in nature and that causes acute neuromascular failure. The condition is quite common in Bangladesh. GBS is an autoimmune and post-infectious immune disease. Objectives: To see the different presentation and outcome of GBS in combined military hospital (CMH) Dhaka. Materials and Methods: This was a retrospective observational study conducted on all the GBS patients admitted in the Neurology Ward of CMH Dhaka from January 2005 to July 2010. Total 25 patients clinical and laboratory data including CSF analysis, electrophysiological study data were collected from patients’ case sheet. Results: Among the 25 GBS patients male was 22 (88%) and female 03(12%) and most common age group affected was 31-40 years comprising of 09(36%) patients. The most common types of GBS patients were acute inflammatory demyelinating polyneuropathy (AIDP) 17(68%) patients and 10(40%) patients were found to have history of upper respiratory tract infection (URTI). Albuminocytological dissociation was found in 20(80%) patients in CSF study. Intravenous immunoglobulin therapy was given to 13(52%) patients, of them 09(36%) patient needed mechanical ventilation; rest 12(48%) patients were treated conservatively. The final outcome was full recovery 22(88%) patients, 02(8%) patients had residual disability and only one patient died after 2 years of GBS. Conclusion: GBS is an important cause of peripheral neuropathy. Patient should be monitored carefully because a significant number of patients ultimately require mechanical ventilation for respiratory failure which may be of sudden onset. JAFMC Bangladesh. Vol 16, No 2 (December) 2020: 44-46

Association of albumin, sodium and potassium levels with the outcome in plasma exchange treated Guillain Barre Syndrome

Guillain Barre Syndrome (GBS) is an autoimmune neuromuscular disease characterized by the acute progressive weakness, with the complication of respiratory distress. It is important to look for appropriate biomarker to predict the outcome of GBS. In this study, we assess three parameters: albumin, sodium and potassium, to know whether there is an association with the outcome of GBS patients.

Covid-19-associated Guillain-Barré syndrome in the first wave of COVID-19 pandemic in Lombardia: Increased incidence or increased seroprevalence?

Several studies reported increased incidence of Guillain-Barre’ Syndrome (GBS) after Zika epidemic, SARS-CoV and MERS, and more recently SARS-CoV-2 infection. We estimate incidence and describe clinical characteristics and outcome of GBS in COVID-19 patients in one of the most affected regions by COVID-19 of the world, Lombardia.

Clinical profile and functional outcome of Guillain-Barre syndrome: Experience from a tertiary care hospital of Bangladesh

Guillain-Barré Syndrome (GBS) is an acute immune-mediated polyradiculoneuropathy with diverse clinical phenotype and functional outcome. In this study, we tried to evaluate clinical profile and outcome of GBS patients admitted in a tertiary care centre of Bangladesh.

Comparison of the Clinical Outcomes of Guillain Barre Syndrome Based on Electrophysiological Subtypes in Pakistani Children.

ObjectiveGuillain Barre syndrome (GBS) is an autoimmune-mediated, acute, symmetrical, flaccid paralysis. Guillain Barre syndrome has different electrophysiological types that carry prognostic significance and tend to differ between adults and children. This study aims to compare the clinical outcome of Guillain Barre syndrome in Pakistani children based on their electrophysiological types to help in understanding and predicting the prognosis.Study designObservational comparative studyPlace & durationThe pediatric department, Shifa International Hospital, Islamabad; all patients with Guillain Barre syndrome seen between 2012 and 2019MethodAll children aged one to 16 years in whom Guillain Barre syndrome was diagnosed based on clinical history, examination, and electrophysiological findings. Institutional review board (IRB) approval was taken and data entered on the designed questionnaire. Chi-square and non-parametric tests were applied for significant association.ResultsTwenty-three children were included in the study. Of these, 14 were males (60.9%) while the mean age was 5.8 (+4.5) years. Acute inflammatory demyelinating polyneuropathy (AIDP) was found to be the predominant type (9; 39.1%) followed by acute motor and sensory axonal neuropathy (AMSAN) (6; 26.1%), Acute motor axonal neuropathy (AMAN) was diagnosed in four (17.4%) patients. Six (26.1%) patients needed mechanical ventilation and 10 patients (43.5%) required intensive care unit (ICU) care. The majority of the patients (18; 78.3%) received intravenous immunoglobulin (IVIG).ConclusionThe study highlights varied electrophysiological types of GBS in Pakistani children, which differ in predominance from previous studies. However, various indicators of poor outcomes that are highlighted in adults, including the older age group, need for mechanical ventilation, and electrophysiological evidence of axonal degeneration, were not significant predictors of outcome in children.

Prediction of Outcome in Patients with Guillain Barre Syndrome—An Egyptian Study

Study Objectives: Guillain-Barre syndrome (GBS) is an acute-onset, monophasic immune-mediated disorder of the peripheral nervous system that often follows an infection. The outcome and prognosis of GBS depend on many factors such as the etiology, clinical features, neurophysiology and immunological parameters. The aim of this study was to assess the factors (clinical, investigatory tools, and therapies) that may affect the outcome of patients with GBS. Patients and methods: this was an analytical observational study that was conducted at Ain Shams university hospitals and Kobri Elkoba Military Hospital including twenty patients with the diagnosis of Guillain Barre Syndrome in the duration from 2016 to 2018. This study included twenty patients with the diagnosis of GBS within two weeks from onset of neurologic symptoms, whom their diagnosis based on the established clinical criteria and verified by investigations. Patients were selected from both genders and aged from 18 to 65 years old. Nerve conduction studies and electromyography were performed within two weeks from admission. Various lines of treatment such as plasma exchange (PE), intravenous immunoglobulins (IVIG) or both were used during the period of admission in hospital. Outcome was assessed by the Hughes functional score (F-score), that was applied to the patients on admission, at end of 4 weeks from onset of neuropathy and at the end of 8 weeks. The final outcome at the end of 8 weeks was classified as follow: Group I: good prognosis (0 - 2) on the Hughes functional score (15 patients) and Group II: poor prognosis (3 - 6) on the Hughes functional score (5 patients). Results: the age of the study population ranged from 18 to 65 years with mean of 36.10 ± 16.08 years. Fifteen (75%) patients were males and 5 (25%) patients were females. There was no statistically significant difference found between poor and good prognosis regarding gender. The most common electrophysiological subtype was demyelinating followed by axonal neuropathy. Most patients (75%) had a good outcome at end of study period. It was found that the different line of treatment administered (plasma exchange or IVIG or both) was not associated with poor or good outcome. The patients who needed mechanical ventilation had significantly poor prognosis. Conclusion: the most common electrophysiological subtype was demyelinating followed by axonal neuropathy. Ascending pattern of weakness was more common than descending pattern in this study population and was not related to prognosis. High Hughes score at admission was associated with poor outcome at 8 weeks.

Electrophysiological Subtypes and Prognostic Factors of Guillain-Barre Syndrome in Northern China

Objectives: To assess the epidemiology of different electrophysiological subtypes of Guillain-Barre syndrome (GBS) and investigate the factors affecting the prognosis of the acute motor axonal neuropathy (AMAN) subtype in northern China.Methods: According to the National Institute of Neurological Disorders and Stroke diagnostic criteria for GBS, 104 consecutive GBS patients were recruited from the Department of Neurology of the Second Hospital of Hebei Medical University, China from 2014 to 2018.Results: Based on nerve conduction studies (NCSs), AMAN was the most common subtype in Northern China, accounting for 58 patients (55.8%). AMAN patients had significantly higher prevalence of antecedent diarrhea, longer duration of hospitalization, and slightly slower recovery than those with acute inflammatory demyelinating polyneuropathy (AIDP), but there was no statistical difference in disease severity or short-term prognosis between AMAN and AIDP. Based on multivariate regression analysis, AMAN patients with antecedent diarrhea (OR = 0.16, 95% CI: 0.03–0.756, p = 0.021) or conduction blocks (CBs) (OR = 0.033, 95% CI: 0.001–0.787, p = 0.035) had dramatically better short-term prognosis. Decreased compound action potential with distal stimulation (dCMAP) amplitude was associated with significant slower speed of recovery(OR = 8.31, 95% CI: 2.55–27.10, p = 0.02).Conclusion: AMAN is still the most common subtype of GBS in northern China. A decline in dCMAP amplitude is predictive factor of a slow recovery and poor outcome of GBS. Diarrhea and CBs may be the factors for better short-term prognosis in AMAN patients in Northern China.

Motor Nerve Conduction Block Predicting Outcome of Guillain-Barre Syndrome.

Introduction: Motor nerve conduction blocks (CBs) could be detected in both acute inflammatory demyelinating polyradiculoneuropathy (AIDP) and acute motor axonal neuropathy (AMAN). We aimed to identify the correlation between CBs and functional outcome in the two subtypes of GBS.Methods: Motor nerve conduction studies were performed in 17 patients with AIDP and 23 with AMAN. All patients were treated with intravenous immunoglobulin, and their disabilities were evaluated with Hughes functional grading scale before treatment, 1 month and 6 months after onset.Results: AMAN with CBs had higher reduction of Hughes grade (indicating more improved outcomes) at 1 month (1.71 ± 0.83 vs. 1 ± 0.67, p = 0.034) than AIDP with CBs. AMAN with CBs had higher reduction of Hughes grade at 1 month (1.71 ± 0.83 vs. 0.56 ± 0.73, p = 0.002) than AMAN without CBs. The reduction of Hughes grade at 1 month showed no significant difference between AIDP with and without CBs.Discussion: Motor nerve CBs in AMAN indicated better prognosis than in AIDP.

S32. Outcome Guillain–Barré of syndrome in tertiary care centers in Thailand (extended study)

Introduction Guillain–Barre syndrome (GBS), a common acute polyneuropathy, is seen worldwide with significant morbidity and mortality. Regional data of GBS in Thailand are sprase. Therefore the aim of this study is to identify clinical characteristics, electrophysiologic changes, clinical course, treatment, and outcome of GBS in Thailand. Methods Retrospective study of GBS patients aged 15 years or older, admitted to Thammasat University Hospital,Bangkok Hospital Medical Center, Phramongkutklao Hospital, and Maharaj Nakorn Chiang Mai Hospital between January 1, 2009 and June 30, 2017. Results Eighty-two patients were found. Demographic characteristics were collected and described as follows; 56% male sex; average age 49 years; Asian 77%, European 9%, and others 10%. Disease subtypes consist of acute inflammatory demyelinating polyneuropathy 69.5%, acute motor axonal neuropathy 14.6%, and others 15.9%. Average GBS disability score at admission was 3.0. Immunotherapy was intravenous immunoglobulin only 91.7%, plasma exchange plus intravenous immunoglobulin 5%, and steroid 3.3%. Average length of stay was 14.8 days; assisted ventilation rate was 22.0%. After the average of 8-month follow-up, average GBS disability score was 1.8, good outcome (score Conclusion Our study suggests that most GBS patients in Thailand are acute inflammatory demyelinating polyradiculoneuropathy (AIDP) subtype and have a good outcome.

Effect of Coexisting Autoimmune Disorders on Clinical Outcome in Guillain-Barre syndrome: An Analysis from National Inpatient Database (P1.163)

Effect of Coexisting Autoimmune Disorders on Clinical Outcome in Guillain-Barre syndrome: An Analysis from National Inpatient Database (P1.163)

Early Prediction Factors of Poor Outcome in Guillain-Barre Syndrome

Early Prediction Factors of Poor Outcome in Guillain-Barre Syndrome

Short-term outcome of Guillain-Barré syndrome: Tertiary centre experience

Introduction: Guillain-Barre syndrome (GBS) is an acute autoimmune disorder of peripheral nerves and their roots. The most common GBS variants are: acute inflammatory demyelinating polyradiculoneuropathy (AIDP), acute motor axonal neuropathy (AMAN), acute motor and sensory axonal neuropathy (AMSAN), Miller-Fisher syndrome (MFS) and other rarer variants. Aim: Evaluation of frequency of GBS variants and analysis of the outcome of the disease in a cohort of patients hospitalized at the Neurology Clinic, Clinical Center of Serbia. Material and Methods: This study included 43 patients with GBS, hospitalized in 2015. The data about clinical characteristics of the disease were collected by a retrospective analysis from electronic medical record. We used methods of descriptive statistics: mean, standard deviation and proportions. Results: Majority of our patients were male with male to female ratio 2.6 : 1. The most common variant in our study was AIDP (41.9%), then AMSAN (7.0%) and AMAN (4.7%). The most common first symptoms of the disease were weakness and numbness in the legs (18.6%). According to the Hughes scale, at admission, most of the patients had a mild form of the disease (65.1%), while at nadir 62.8% were non ambulatory, and 2.3% of patients required assisted ventilation. The outcome of the disease was favorable in 74.4% of patients, while 11 patients (25.6%) had a significant functional disability on discharge. In (4.7%) 2 patients of our cohort, lethal outcome was recorded. Conclusion: GBS is a rapidly progressive, monophasic disease, which has a generally good prognosis today, thanks to modern therapy. Our further research will be focused on the long-term outcome of GBS.

Increased Frequency of Guillain-Barré Syndrome in HIV Infection: A Prospective Cohort Study

Background: Guillain-Barre syndrome (GBS) has been reported in HIV-positive individuals, but the incidence and characteristics in this group of patients has not systematically been investigated beyond case reports and retrospective series. The aim of this study was to compare the incidence and characteristics of GBS in HIV positive and -negative individuals. Methods: We performed a prospective, comparative study over a 3 ½ year period in the Western Cape province of South Africa. All adult patients with GBS were included and classified into 2 groups based on HIV status. The two groups were compared with regards to clinical, electrophysiological and laboratory features. Patients were followed until stable or recovered, for a maximum of 12 months. Results: 28 patients were included in the study, of which 15 were HIV-positive. Using estimated HIV prevalence data for the same geographical area during the study period, the incidence of GBS in HIV-positive patients was calculated to be 18.74, 95% CI [7.69, 40.60] times higher than in HIV-negative patients. Except for the frequency of hyponatraemia, there were no statistically significant differences between the 2 groups with regards to presenting features, severity of illness, GBS subtypes, and treatment response. GBS occurred in all stages of HIV infection, and was the presenting feature of HIV infection in 13 patients. Interpretation: The incidence of GBS is strikingly increased in HIV infection. The reason for this is still uncertain, but can probably be explained by immune dysregulation. HIV infection does not appear to influence the short term outcome of GBS.

Positive Functional Outcome in Guillain-Barre Syndrome as Initial Presentation of Acute HIV Seroconversion: A Case Report

Positive Functional Outcome in Guillain-Barre Syndrome as Initial Presentation of Acute HIV Seroconversion: A Case Report