Very-early Guillain-Barré syndrome: Clinical characteristics, electrophysiological findings, and short-term functional outcome

Abstract

Background: Guillain-Barré syndrome (GBS) patients who present very early (< 4 days) to health-care services generally have severe clinical forms due to rapid progression. Little information exists on the clinical and short-term functional prognosis in patients with very-early GBS (VEGBS). Methods: A prospective cohort study was conducted. We performed Kaplan-Meier survival analysis to observe the recovery of independent gait between groups, where a log-rank value < 0.05 was considered significant. All statistical analyzes were performed using SPSS version 22. Results: Ninety-nine patients were included in the study. Mean age was 46.7 ± 16.7 years, 61.9% were male. Regarding nerve conduction studies, the most frequent electrophysiological variants in the very early-onset GBS group were axonal (38.7%). Twenty-three percent were classified as equivocal. In the GBS group > 4 days, the most frequent electrophysiological variant was acute inflammatory demyelinating polyneuropathy (52.1%). Conclusion: Patients with VEGBS do not present different clinical characteristics, nor severity or poor short-term outcome in our population compared to different GBS presentations. Only mechanical ventilation requirement and distal compound muscle action potential reduction are associated with poor outcome in this subset of patients.

Guillain-Barre syndrome with hyponatremia, more than a simple finding

“…There have been case reports of patients presenting with encephalopathy secondary to hyponatremia who, at the time of review, found GBS or the onset of SIADH symptoms with subsequent development of GBS 17,18 . Our previously published data involving patients with very early GBS (< 4 days of evolution) found a higher prevalence of hyponatremia (37%) without a higher prevalence of dysautonomia, being approximately double what was found in the current study and persisting when compared with other international cohorts 19 .…”