Fatal Guillain-Barré syndrome

Lawn, Nicholas; Wijdicks, Eelco F. M.

doi:10.1212/wnl.52.3.635

Cited by 85 publications

(67 citation statements)

References 9 publications

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“…Mortality rate ranges from 2-13% in different studies. Dana I, et al 22 study shows 5%, Italian GBS study group shows (up to 12%), Cherg Q, et al (2000) 18 shows 8%, Nicholas, et al (1998) 20 shows 4%, Italian study (1988-93) 9%, South England (1993-94) shows 9%,Voston MGH (1962-81) shows 2%, Brazil study (2003) shows 10% mortality among all GBS case. In our study mortality rate was 7% which is comparable to other studies.…”

Section: Discussionmentioning

confidence: 95%

Guillain Barre Syndrome: Major Cause of Acute Flaccid Paralysis in Children and Adolescents of Nepal

Sharma

Singh

Shah

2011

J. Nepal Paedtr. Soc.

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Introduction. Guillain Barre Syndrome (GBS) is a post infectious polyneuropathy involving mainly motor but sometimes sensory and autonomic nerves. It is an acquired disease of the peripheral nerves that is characterized by rapidly progressing paralysis, areflexia and albumino-cytological dissociation in CSF. Methodology: Prospective, descriptive, observational, hospital based study was carried out to find out the clinico-epidemiological features of GBS including existing treatment modalities and its outcome. All cases fulfilled the criteria for AFP (Acute flaccid Paralysis) surveillance was included. Cases were reviewed for full medical history and examinations. To confirm the diagnosis, necessary investigations were carried out and combined with clinical symptoms. Results: Thirty patients were included in the study during study period. Among them 90% were diagnosed as GBS, 7.4% patients of GBS were associated with hypokalemic paralysis, 7.4% diagnosed as transverse myelitis and 3.7% diagnosed as idiopathic neuropathy. Different types of GBS were classified as AIDP (Acute inflammatory demyelinating polyneuropathy) 62.96%, AMAN (Acute motor axonal neuropathy) -25.52%, AMASAN (Acute motor and sensory axonal neuropathy) -3.3% and MFS (Miller fisher's syndrome) -6.6% according to NCV result. Male female ratio is 1.7:1.0. There was 14.8% patients had relapse within 5 year. Associated diseases were URTI, pneumonia, sore throat and diarrhea. Facial Nerve palsy was commonest cranial nerve involvement.Sixty percentage of patients presented with sensory symptoms. There was transient bowel and bladder involvement in 20% of the cases. 69.2% patients became bed ridden at the nadir. There was albumin-cytological dissociation in 80% case. Majority of patients improved with supportive treatment alone, 19.5% patient required ventilator support among them 40% died. 7.4% of cases expired during treatment. Half of the patients fully recovered within 3 months. Conclusion: GBS is the commonest cause of AFP, AIDP being commonest subtype in our setting. We have to improve our existing treatment facilities and extend to different centers to detect and treat GBS. Most of the patients improve with supportive treatment alone. Ventilator support indicates grave prognosis.

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Section: Discussionmentioning

confidence: 95%

Guillain Barre Syndrome: Major Cause of Acute Flaccid Paralysis in Children and Adolescents of Nepal

Sharma

Singh

Shah

2011

J. Nepal Paedtr. Soc.

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“…7 Time to developing DVT or pulmonary embolus varies from 4 to 67 days after onset. 7,8 Children have a very low incidence of DVT. 9 There is a lack of clinical studies that address methods of prophylaxis against thrombosis in GBS, duration of prophylaxis, or monitoring of patients at risk for thrombosis.…”

Section: Prophylaxis For Deep Vein Thrombosismentioning

confidence: 99%

Supportive Care for Patients With Guillain-Barré Syndrome

Hughes¹,

Wijdicks²,

Benson³

et al. 2005

Arch Neurol

245

161

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“…Approximately one third of GBS patients are admitted to an intensive care unit (ICU); many require mechanical ventilation (MV), often for prolonged periods [2][3][4]. During this critical phase, they are at risk for systemic complications with the potential for substantial morbidity and consequent mortality [5,6]. These severely afflicted patients have a less favourable prognosis for functional recovery, suffer greater long-term disability, and expend substantial personal and health-care costs [7].…”

Section: Introductionmentioning

confidence: 99%