Clinical and demographic characteristics of Guillain-Barre syndrome

Öz

Objective: We aimed to assess the epidemiological, clinical, laboratory, electrophysiological findings in patients with Guillain-Barre´ syndrome Methods: We performed a retrospective analysis of 33 patients with GBS admitted to Dicle University Medical Faculty Hospital neurology clinic from January 2011 to March 2014. Were reviewed. Epidemiological, clinical, therapeutical and evolutionary data were collected. Results: Thirty-six patients with the diagnosis of GBS included 22 males and 14 females. The average age at diagnosis was 41.3±21.38years with a wide age range (11–82) and a peak between 36 and 55 years. Based on clinical and electrophysiological features, 61.1% of the patients had acute inflammatory demyelinating polyneuropathy (AIDP), 22.2% acute motor and sensory axonal neuropathy 11.1% had acute motor axonal neuropathy, and 5.6% had Miller Fisher Syndrome. In 28 of 36 patients (77.0%), potential trigger factors could be identified. Respiratory tract infection was the most common infection (36.1%), followed by gastrointestinal infection (27.8%), after surgery (11.1%), vaccination (2.8%) Conclusion: Our study showed that surgery may be triggered GBS and suggesting a geographical and environmental factor involved in GBS etiopathogenesis.

Anahtar Kelimeler

• Guillain-Barre syndrome, clinical findings, surgery, geographical location

Guillain-Barre sendromunda klinik ve demografik özellikler

Öz

Amaç: Guillain-Barre Sendrom'lu (GBS) hastaların epidemiyolojik, klinik, laboratuvar ve elektrofizyolojik bulguları değerlendirilmesi amaçladık. Yöntemler: Çalışmaya Güneydoğu Anadolu bölge nüfusunu temsil ettiği düşünülen Dicle üniversitesi tıp fakültesi hastanesi nöroloji kliniğine Ocak 2011 ve Mart 2014 yılları arasında başvurmuş ve yatırılarak takip edilen 36 olgunun dosya kayıtları geriye dönük olarak incelendi. Tüm hastaların demografik, klinik, laboratuar, BOS, elektrofizyolojik ve tedavi verileri kaydedildi. Bulgular: Guillain-Barre Sendromu tanısı alan 36 olgunun 22 (%61,1)\'u erkek ve 14 (%38,9)\'i kadındı. Klinik ve elektrofizyolojik verilerine göre 22 hasta (%61,1) Akut İnflamatuar Demiyelinizan Polinöropati (AIDP), 4 hasta (%11,1) Akut Motor Aksonal Nöropati (AMAN), 8 hasta (%22,2) Akut Motor ve Sensoryal Aksonal nöropati (AMSAN) ve 2 hasta (%5,6) Miller Fisher Sendromu (MFS) olarak değerlendirildi. Hastaların çoğunda öncül bir hastalık mevcuttu. 13 hastada (%36,1) üst solunum yolu enfeksiyonu (ÜSYE) , 10 hastada (%27,8) gastroenterit, 4 hastada(%11,1) cerrahi, bir hastada(%2,8) aşı öyküsü mevcuttu. Sonuç: Çalışmamız GBS'yi cerrahi işlemlerin tetikleyebileceğini ve GBS\'nin etyopatogenezinde coğrafyanın ve çevresel faktörlerin önemini göstermektedir.

Anahtar Kelimeler

• Guillain-Barre sendromu, klinik bulgular, cerrahi, coğrafi bölge

Kaynakça

1. Van Doorn PA, Ruts L, Jacobs BC. Clinical features, patho- genesis, and treatment of Guillain-Barré syndrome. Lancet Neurol 2008;7:939–950.
2. Pithadia AB, Kakadia N. Guillain–Barre syndrome (GBS). Pharmacol Rep 2010;62:220-232.
3. Algahtani H, Moulin DE, Bolton CF, Abulaban AA. Guil- lain–Barre syndrome following cardiac surgery. Difficult diagnosis in the intensive care unit. Neurosciences (Ri- yadh) 2009;14:374–378.
4. Campbell AJ, McKinlay K, Scott NB. Guillain–Barre syn- drome after cardiopulmonary bypass. J Cardiothorac Vasc Anesth 2009;23:82–83.
5. McGrogan A, Madle G, Seaman HE, De Vries CS. The epi- demiology of Guillain-Barré syndrome worldwide. Neuro- epidemiology 2009;32:150–155.
6. Korinthenberg R, Schessl J, Kirschner J. Clinical presentation and course of childhood Guillain-Barré syndrome: a pro- spective multicentre study. Neuropediatrics 2007;38:10–17.
7. Soysal A, Aysal F, Calıskan B.Clinico-electrophysiological findings and prognosis of Guillain-Barre´ syndrome 10 years experienceActa. Neurol Scand 2011;123:181–186
8. The Italian Guillain-Barré Study Group: The prognosis and main prognostic indicators of GuillainBarré syndrome. A multicentre prospective study of 297 patients. Brain 1996;119:2053–2061.

9. Van Koningsveld R, Steyerberg EW, Hughes RAC, et al. A clinical prognostic scoring system of Guillain-Barré syn- drome. Lancet Neurol 2007;6:589–594.
10. Hughes RA, Newsom-Davis JM, Perkin GD, Pierce JM. Controlled trial prednisolone in acute polineuropathy. Lan- cet 1978;2:750–753.
11. Medical Research Council. Aids to the examination of the peripheral nervous system, Memorandum no. 45, Her Maj- esty’s Stationery Office, London, 1981.
12. Jiang GX, Cheng Q, Ehrnst A, Link H, De Pedro-Cuesta J. Guillain-Barre´ syndrome in Stockholm County, 1973– 1991. Eur J Epidemiol 1997;13:25–32.
13. Lyu R-K, Tang L-M, Cheng S-Y, et al. Guillain-Barre´ syn- drome in Taiwan: a clinical study of 167 patients. J Neurol Neurosurg Psychiatry 1997;63:494–450.
14. Gazioğlu S, Tomak T, Boz C. Guillain-BarreSendromun- da Klinik Özellikler ve Prognoz. J Neurol Sci [Turk] 2013;34:124-134.
15. Markoula S, Giannopoulos S, Sarmas I, et al. Guillain- Barre syndrome in northwest Greece. Acta Neurol Scand 2007;115:167-173.
16. González-Suárez et al. Guillain-Barré Syndrome: Natural history and prognostic factors: a retrospective review of 106 cases. BMC Neurology 2013;13:95.
17. Cuadrado JI, de Pedro Cuesta J, Ara JR, et al. Guillain- Barré syndrome in Spain, 1985–1997: epidemiological and public health view. Eur Neurol 2001;46:83–91.
18. Alandro-Benito Y, Conde-Sendín MA, Muñoz-Fernán- dez C, et al. Síndrome de Guillain-Barré en el área norte de Gran Canaria e isla de Lanzarote. Rev Neurol (Barc.) 2002;35:705–710.
19. Gensicke H, Datta AN, Dill P, et al. Increased incidence ofGuillain–Barre syndrome after surgery. Eur J Neurol 2012;19:1239–1244.
20. Hogan JC, Briggs TP, Oldershaw PJ. Guillain–Barre syn- drome following cardiopulmonary bypass. Int J Cardiol 1992;35:427–428.
21. Renlund DG, Hanley DF, Traill TA. Guillain–Barre syn- drome following coronary artery bypass surgery. Am Heart J 1987;113:844
22. Oucquey D, et al. Clinical and serological studies in a series of 45 patients with Guillain–Barre syndrome. J Neurol Sci 1991;104:56–63.
23. Vucic S, Kiernan MC, Cornblath DR. Guillain-Barre´ syn- drome: an update. J Clin Neurosci 2009;16:733–741.
24. Mori M, Kuwabara S, Fukutake T, et al. Clinical features and prognosis of Miller Fisher syndrome. Neurology 2001;56:1104-1106.
25. Kushnir M, Klein C, Pollak L, Rabey JM. Evolving pattern of Guillain-Barre syndrome in a community hospital in Is- rael. Acta Neurol Scand 2008;117:347-350.