Experience with Guillain-Barré syndrome in a neurological Intensive Care Unit

Abstract

Introduction: Guillain-Barré syndrome, an acute polyradiculoneuropathy that presents with weakness and areflexia, is the most common cause of acute flaccid paralysis. In certain patients, respiratory failure is secondary to this disorder, eventually causing patients to require mechanical ventilation and experience additional complications due to diminished respiratory support and related mobility limitations. Prognoses for most of these cases are positive; treatment consists of basic support combined with plasmapheresis or administration of immunoglobulins.Objective: This study sought to describe the socio-demographic, clinical, laboratory and neurophysiological characteristics of patients with Guillain-Barré syndrome who were hospitalised in the Intensive Care Unit of the Neurological Institute of Colombia between 2006 and 2012.Methodology: This study presents a case series. Results: We surveyed 25 patients (32% female and 68% male) with Guillain-Barré syndrome and an average age of 54 years. Sixty per cent of these patients were admitted between days 3 and 7 after symptom onset; 64% had a history of respiratory infection and 20% had a history of intestinal infection. In addition, 84% of the patients presented with albuminocytological dissociation. We observed the following clinical subtypes of Guillain-Barré syndrome: inflammatory demyelinating polyneuropathy in 32%, acute motor-sensory axonal neuropathy in 28%, acute motor axonal neuropathy in 28%, and Miller Fisher syndrome in 12%. Conclusions:In this descriptive study of a group of critical care patients with GBS, results depended on patients' clinical severity at time of admission. Our findings are similar to results published in the international literature.Conclusiones: Esta descripción corresponde a un grupo de pacientes críticos con SGB; su desenlace estuvo determinado por la severidad del cuadro clínico al ingreso. Nuestros hallazgos son comparables con lo publicado en la literatura mundial.

Guillain–Barré syndrome in Colombia: where do we stand now?

“…1). Table 1 summarizes the main characteristics of all studies [14,16,25,[31][32][33][34][35][36][37][38][39][40][41][42][43].…”

Nationwide study of therapeutic plasma exchange vs intravenous immunoglobulin in Guillain‐Barré syndrome

“…Recently published comparative and noncomparative studies of GBS outcomes after treatment with TPE and/or IVIG have consisted primarily of case reports or case series from single institutions in developing countries, at which the choice between TPE and IVIG is largely dependent on economic considerations . Given the established equivalence between TPE and IVIG as effective treatments for GBS, it is important to evaluate patient‐ and hospital‐level characteristics that may affect treatment selection.…”

Clinical and electrophysiological characteristics of Guillain‐Barré syndrome in Colombia

“…As previously reported by other Colombian studies completed in 2005, our results showed a predominance of the demyelinating form (AIDP) (70%) . Only one study in an intensive care unit (ICU) reported a higher prevalence of the axonal form (AMAN) . This may be explained by a greater need of ventilatory support among patients with AMAN .…”

“…4,7 Only one study in an intensive care unit (ICU) reported a higher prevalence of the axonal form (AMAN). 16 This may be explained by a greater need of ventilatory support among patients with AMAN. 17 It has been documented that AMAN is more common in Japan, China, and some countries in Central and South America.…”