medigraphic.com
Academia Mexicana de Neurología, A.C.

2012, Number 1

<< Back Next >>

Rev Mex Neuroci 2012; 13 (1)

Guillain-Barré Syndrome in a reference hospital from Mexico

Carrillo-Pérez DL, García-Ramos G, Ruano-Calderón LÁ, Sosa-Hernández JL, Méndez-Castillo JJ

Language: Spanish
References: 44
Page: 15-21
PDF size: 221.51 Kb.


ABSTRACT

Introduction: Guillain-Barré syndrome (GBS) could have a different frequency, as well as clinical and neurophysiological presentation in the mestizo population, as compared with Caucasians. However, information on GBS in Latin America is scarce. Objective: To describe the neurophysiological variants and clinical characteristics of GBS patients of a reference hospital from Mexico. Methods: We performed a descriptive and retrospective analysis on clinical records of patients diagnosed with GBS from February 2004 to February 2010. Clinical and neurophysiological (Asbury criteria) characteristics, therapeutics and short-term follow-up were analyzed. Results: A total of 25 patients (mean age: 38 years, range: 18-59 years) with complete clinical data and follow-up were included: 14 men and 11 women (56% had the antecedent of infection in the previous 4 weeks). Seventy-six percent of patients grouped into the 4 and 5 grades in the Hughes functional scale for GBS. Protein-cytological dissociation was observed in 81% of cases. A 39.1% of patients corresponded to the acute motor and sensory axonal neuropathy (AMSAN), 26.1% to acute motor axonal neuropathy (AMAN), 26.1% to acute inflammatory demyelinating polyneuropathy (AIDP), and 8.7% to the Miller Fisher clinicalneurophysiological pattern. In all, 83% of AIDP cases presented during spring. The axonal variants had the largest hospital stay (21.7 vs. 10.9 days, p = 0.008) and a trend for more cases needing mechanical ventilation (33.3% vs. 0%, p = 0.12). Conclusion: We observed some differences with respect to information from occidental countries, among them, a high frequency of axonal variants, which were more severe and had the longest hospital stay.


REFERENCES

  1. Asbury AK, Cornblath DR. Assesment of current diagnosis criteria for Guillain-Barré syndrome. Ann Neurol 1990; 27(Suppl.): S21-S24.

  2. Bradshaw DY, Jones HR Jr. Guillain-Barré syndrome in children: clinical course, electrodiagnosis, and prognosis. Muscle Nerve 1992; 15: 500-6.

  3. Asbury AK. New concepts of Guillain-Barré syndrome. J Child Neurol 2000; 15: 183-91.

  4. Yuki N, Yoshino H, Sato S, Miyatake T. Acute axonal polyneuropathy associated with anti-GM1, antibodies following Campylobacter jejuni enteritis. Neurology 1990; 40: 1900-2.

  5. Rees JH, Soudain SE, Gregson NA, Hughes RAC. Campylobacter jejuni infection and Guillain-Barré syndrome. N Engl J Med 1995; 333: 1374-9.

  6. Ress JH, Gregson NA, Hughes RAC. Anti-ganglioside antibodies in Guillain-Barré syndrome and their relationship to Campylobacter jejuni infection. Ann Neurol 1995; 38: 809-16.

  7. Hadden RDM, Cornblath DR, Hughes RAC, Zielasek J, Hartung HP, Toyka KV, et al. Electrophysiological classification of Guillain-Barré syndrome. Ann Neurol 1998; 44: 780-8.

  8. Feasby TE, Gilbert JJ, Brown WF, Bolton CF, Hahn AF, Koopman WF, Zochodne DW. Severe axonal degeneration in acute Guillain-Barré polyneuropathy. Brain 1986; 109: 1115-26.

  9. McKhann GM, Cornblath DR, Griffin JW, Ho TW, Li CY, Jiang Z, Wu HS, Zhaori G, Liu Y, Jou LP. Acute motor axonal neuropathy: A frequent cause of acute flaccid paralysis in China. Ann Neurol 1993; 33: 333-42.

  10. Griffin JW, Li CY, Ho TW, Xue P, Macko C, Gao CY, Yang C, et al. Guillain-Barré syndrome in northern China: the spectrum of neuropathologic changes in clinically defined cases. Brain 1995; 118: 577-95.

  11. Ho TW, Mishu B, Li CY, Gao CY, Cornblath DR, Griffin JW, Asbury AK, et al. Guillain-Barré syndrome in northern China: Relationship to Campylobacter jejuni infection and antiglycolipid antibodies. Brain 1995; 118: 597-605.

  12. Lyu RK, Tang LM, Cheng SY, Hsu WC, Chen ST. Guillain-Barré syndrome in Taiwan: a clinical study of 167 patients. J Neurol Neurosurg Psychiatry 1997; 63: 494-500.

  13. Massaro ME, Rodriguez EC, Pociecha J, Arroyo HA, Sacolitti M, Taratuto AL, Fejerman N, et al. Nerve biopsy in children with severe Guillain- Barré syndrome and inexcitable motor nerves. Neurology 1998; 51: 394-8.

  14. Waxman SG. Do demyelinating diseases involve more than myelin? Nat Med 2000; 6: 738-9.

  15. Chowdhury D, Arora A. Axonal Guillain-Barré syndrome: a critical review. Acta Neurol Scand 2001; 103: 267-77.

  16. Tekgul H, Serdaroglu G, Tutuncuoglu S. Outcome of axonal and demyelinating forms of Guillain-Barré syndrome in children. Pediatr Neurol 2003; 28: 295-9.

  17. Shafqat S, Khealani BA, Awan F, Abedin SE. Guillain-Barré syndrome in Pakistan: similarity of demyelinating and axonal variants. Eur J Neurol 2006; 13: 662-5.

  18. Nagasawa K, Kuwabara S, Misawa S, Fujii K, Tanabe Y, Yuki N, Hattori T, Kohno Y. Electrophysiological subtypes and prognosis of childhood Guillain-Barré syndrome in Japan. Muscle Nerve 2006; 33: 766-70.

  19. Ramos-Alvarez M, Bessudo L, Sabin AB. Paralytic syndromes associated with noninflammatory cytoplasmic or nuclear neuronopathy. Acute paralytic disease in Mexican children, neuropathologically distinguishable from Landry-Guillain-Barré syndrome. JAMA 1969; 207: 1481-92.

  20. Maldonado R, Otero E. El síndrome de Guillain-Barré. Concepto actual y las características que adopta en la población mexicana. Rev Inst Nal Neurol 1978; 3-4: 125-54.

  21. Gorodezky C, Varela B, Castro-Escobar LE, Chávez-Negrete A, Escobar- Gutiérrez A, Martínez-Mata J. HLA-DR antigens in Mexican patients with Guillain-Barre syndrome. J Neuroimmunol 1983; 4: 1-7.

  22. Aguilar-Rebolledo F, Rendón-Macías ME, Escobar-Barrios E. [Pain in the Guillain-Barré syndrome in children]. Gac Med Mex 1997; 133: 63-70.

  23. Téllez-Zenteno JF, Jacinto-Tinajero JC, Avila-Funes A, García-Ramos G, Negrete-Pulido O, Senties-Madrid H. Guillain-Barré syndrome. Experience in a third level hospital. Rev Invest Clin 2001; 53: 311-14.

  24. Rábago-Cervantes R, González-Jaime JJ, Becerra-Leyva G, Quintero- Reyes MA, Ruiz-Sandoval JL. Síndrome de Guillain-Barré. Hallazgos clínicos y electrofisiológicos. Rev Mex Neuroci 2002; 3: 358.

  25. Hafer-Macko C, Asbury AK, Ramos-Alvarez M, Ho TW, Bessudo L, et al. Pathology of noninflammatory acute flaccid paralysis in Mexico: similarities an contrasts with recent cases studied in China. Acta Pediatr Mex 2004; 25: 168-74.

  26. Melano-Carranza E, Carrillo-Maravilla E, Ávila-Funes JA, Gulías-Herrero A, Ávila-Funes JA. Síndrome de Guillain-Barré en el anciano: un estudio retrospectivo. Arch Neurocien 2004; 9: 76-9.

  27. Gonzaìlez-Rivera A, Chico-Aldama P, Arzate-Barbosa P, Rodriìguez- Pinto M, Mckhann-Guy M, Lobato Cecilia, Nachamkin Irving, et al. Epidemiología del síndrome de Guillain-Barré asociado a Campylobacter jejuni en el INP. Acta Pediatr Mex 2006; 27: 300-3.

  28. Nachamkin I, Arzarte BP, Ung H, Lobato C, Gonzalez RA, Rodriguez P, Garcia BA, et al. Patterns of Guillain-Barre syndrome in children: results from a Mexican population. Neurology 2007; 69: 1665-1671.

  29. Zúñiga-González EA, Rodríguez-de la Cruz A, Millán-Padilla J. [Electrophysiological subtypes of Guillain-Barré syndrome in Mexican adults]. Rev Med Inst Mex Seguro Soc 2007; 45: 463-8.

  30. Ruiz-Sandoval JL, Chiquete E, Andrade-Ramos MA, Álvarez-Palazuelos LE, Lima-Ojeda JMV. Guillain-Barré Syndrome in a Referral Center of Mexico: High Frequency of Hand-Weakness Onset, Axonal and Motor Variants [Abstract P07.096]. Neurology 2008; (Suppl): 78.

  31. Winer JB, Hughes RA, Greenwood RJ, Perkin GD, Healy MJ. Prognosis in Guillain-Barré syndrome. Lancet 1985; 1: 1202-3.

  32. Govoni V, Granieri E, Tola MR, Casetta I, Ruppi P, Vaghi L. The frequency of clinical variants of Guillain-Barré syndrome in Ferrara, Italy. J Neurol 1999; 246: 1010-14.

  33. Tang J, Dai Y, Li M, Cheng M, Hong S, Jiang L, Cai F, Zhong M. Guillain- Barré syndrome in Chinese children: a retrospective analysis. Pediatr Neurol 2011; 45: 233-7.

  34. Rocha MS, Brucki SM, Carvalho AA, Lima UW. Epidemiologic features of Guillain-Barré syndrome in São Paulo, Brazil. Arq Neuropsiquiatr 2004; 62: 33-7.

  35. Tabanella G, Nowzari H. Cytomegalovirus-associated periodontitis and Guillain-Barré syndrome. J Periodontol 2005; 76: 2306-11.

  36. Tam CC, O’Brien SJ, Petersen I, Islam A, Hayward A, Rodrigues LC. Guillain-Barré syndrome and preceding infection with campylobacter, influenza and Epstein-Barr virus in the general practice research database. PLoS One 2007; 2: e344.

  37. Sharma MB, Chaudhry R, Tabassum I, Ahmed NH, Sahu JK, Dhawan B, Kalra V. The presence of Mycoplasma pneumoniae infection and GM1 ganglioside antibodies in Guillain-Barré syndrome. J Infect Dev Ctries 2011; 5: 459-64.

  38. Medina-González R, Chávez-García R, Chiquete E, Paredes-Casillas P, Navarro-Bonnet J, Ruiz-Sandoval JL. Síndrome de Guillain-Barré asociado a dengue. Reporte de caso. Rev Mex Neuroci 2011; 12: 159-61.

  39. Baxter R, Lewis N, Bakshi N, Vellozzi C, Klein NP; the CISA Network. Recurrent Guillain-Barre Syndrome Following Vaccination. Clin Infect Dis 2012; 54: 800-4.

  40. Vidal P, Reyna J, Saldaña P, Richardson VL. Events temporarily associated with anti-influenza A (H1N1) vaccination in Mexico. Arch Med Res 2011; 42: 627-32.

  41. Cheng J, Kahn DE, Wang MY. The acute motor-sensory axonal neuropathy variant of Guillain-Barré syndrome after thoracic spine surgery. J Neurosurg Spine 2011; 15: 605-9.

  42. Algahtani H, Moulin DE, Bolton CF, Abulaban AA. Guillain-Barre syndrome following cardiac surgery. Difficult diagnosis in the intensive care unit. Neurosciences (Riyadh) 2009; 14: 374-8.

  43. Schottlender JG, Lombardi D, Toledo A, Otero C, Mazia C, Menga G. Compromiso respiratorio en el syndrome de Guillain-Barré. Medicina (Buenos Aires) 1999; 59: 705-9.

  44. Paradiso G, Tripoli J, Galicchio S, Fejerman N. Epidemiological, clinical and electrodiagnostic findings in childhood Guillain-Barré syndrome: A reappraisal. Ann Neurol 1999; 46: 701-1.




2020     |     www.medigraphic.com