Clinico-electrophysiological profile and predictors of functional outcome in Guillain–Barre syndrome (GBS)

Verma, Rajesh; Chaudhari, Tejendra S; Raut, Tushar Premraj; Garg, Ravindra Kumar

doi:10.1016/j.jns.2013.09.002

Cited by 51 publications

(55 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In previous studies, axonal subtype of GBS has been associated with poor outcome. However, our study did not find significant associations between axonal GBS and poor outcome irrespective of which electrodiagnostic criteria used.…”

Section: Discussionmentioning

confidence: 52%

“…We also found that patients with MFS improved irrespective of immunotherapy, confirming findings from previous studies. 17,19 In previous studies, [20][21][22][23][24][25] axonal subtype of GBS has been associated with poor outcome. However, our study did not find significant associations between axonal GBS and poor outcome irrespective of which electrodiagnostic criteria used.…”

Section: Discussionmentioning

confidence: 96%

See 1 more Smart Citation

The utility of Guillain‐Barré syndrome prognostic models in Malaysian patients

Tan

Razali

Goh

et al. 2019

J Peripheral Nervous Sys

View full text Add to dashboard Cite

Guillain‐Barré syndrome (GBS) is an acute immune‐mediated neuropathy that has variable disease course and outcome. The Erasmus GBS outcome score (EGOS), modified EGOS (mEGOS), and Erasmus GBS respiratory insufficiency score (EGRIS) are prognostic models designed to predict the functional outcome of GBS patients at 6 months (EGOS and mEGOS) and the need for mechanical ventilation within a week of admission (EGRIS). The models were primarily developed in the Dutch GBS population, and thus the usefulness of these models in other GBS cohorts is less clear. In the current study, we aimed to validate mEGOS, EGOS, and EGRIS in Malaysian GBS patients. A total of 107 patients with GBS and its variants were consecutively recruited. Patients with GBS and Miller Fisher syndrome (MFS) were analysed separately. In the GBS cohort, high mEGOS and EGOS scores were significantly correlated with poor outcome at 6 months (mEGOS on admission: r = .381, P = .005; mEGOS at day 7 of admission: r = .507, P < .001; EGOS: r = .484, P < .001). However, there were no significant correlations between mEGOS or EGOS and outcome in patients with MFS (mEGOS on admission: r = .152, P = .523; mEGOS at day 7 of admission: r = .008, P = .973; EGOS: r = .110; P = .644). The score of EGRIS for GBS patients with mechanical ventilation was significantly higher than those patients without mechanical ventilation (4 ± 2 vs 3 ± 1; P < .001). We conclude that mEGOS and EGOS are clinically useful and relevant to the Malaysian GBS population but not in patients with classic MFS. EGRIS could be used to predict the need for mechanical ventilation in our local GBS patients.

show abstract

Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 96%

The utility of Guillain‐Barré syndrome prognostic models in Malaysian patients

Tan

Razali

Goh

et al. 2019

J Peripheral Nervous Sys

View full text Add to dashboard Cite

show abstract

“…Similar to other studies, we observed age ≥40 years as an independent risk factor for GBS deaths (Alshekhlee et al, ; Lawn and Wijdicks, ; Netto et al, ; van den Berg et al, ; Wong et al, ) . Involvement of bulbar nerves is a known strong risk factor for poor outcome, but not death, from GBS (Gonzalez‐Suarez et al, ; Singh et al, ; Verma et al, ) and so is respiratory failure (Netto et al, ; Singh et al, ; Sundar et al, ) . We also observed the association of longer progressive phase (van den Berg et al, ) and dys‐autonomia with GBS deaths (Alshekhlee et al, ; Koeppen et al, ; Netto et al, ) .…”

Section: Discussionmentioning

confidence: 99%

High mortality from Guillain‐Barré syndrome in Bangladesh

Ishaque

Islam

Ara

et al. 2017

J Peripheral Nervous Sys

View full text Add to dashboard Cite

Although Guillain-Barré syndrome (GBS) has higher incidence and poor outcome in Bangladesh, mortality from GBS in Bangladesh has never been explored before. We sought to explore the frequency, timing, and risk factors for deaths from GBS in Bangladesh. We conducted a prospective study on 407 GBS patients who were admitted to Dhaka Medical College Hospital, Dhaka, Bangladesh from 2010 to 2013. We compared deceased and alive patients to identify risk factors. Cox regression model was used to adjust for confounders. Of the 407 GBS patients, 50 (12%) died, with the median time interval between the onset of weakness and death of 18 days. Among the fatal cases, 24 (48%) were ≥40 years, 36 (72%) had a Medical Research Council sum score ≤20 at entry, 33 (66%) had a progressive phase <8 days, and 27 (54%) required ventilation support. Ten patients (20%) died due to unavailability of ventilator. The strongest risk factor for deaths was lack of ventilator support when it was required (HR: 11.9; 95% confidence interval [CI]: 4.6-30.7). Other risk factors for death included age ≥40 years (HR: 5.9; 95% CI: 2.1-16.7), mechanical ventilation (HR: 2.3; 95% CI: 1.02-5.2), longer progressive phase (>8 days) (HR: 2.06; 95% CI: 1.1-3.8), autonomic dysfunction (HR: 1.9; 95% CI: 1.05-3.6), and bulbar nerve involvement (HR: 5.4; 95% CI: 1.5-19.2). In Bangladesh, GBS is associated with higher mortality rates, which is related to lack of ventilator support, disease severity, longer progressive phase of the disease, autonomic dysfunction, and involvement of the bulbar nerves.

show abstract

“…cardiac conduction defect or arrhythmia) in GBS, which can result in unexpected death. Dysautonomia can therefore influence the overall outcome of GBS . However, the precipitating factors for the development of dysautonomia in GBS have only rarely been investigated.…”

Section: Discussionmentioning

confidence: 99%