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Academia Mexicana de Neurología, A.C.

2015, Number 2

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Rev Mex Neuroci 2015; 16 (2)

Clinical description and relationship with the hospital stay of patients with Guillain-Barré Syndrome in community hospital in México

Medina BS, Vargas MD, Rodríguez LI, Orozco NA, Hernández RH

Language: Spanish
References: 28
Page: 3-15
PDF size: 231. Kb.


ABSTRACT

Introduction: In 1916 Barré and Strohl first described the condition later known as Guillain Barré syndrome (GBS). GBS is an immune-based inflammatory demyelinating polyradiculoneuropathy. It is self-limiting, rapidly progressive and potentially lethal.
Objectives: To identify the clinical presentation, evolution, prognosis, treatment and local epidemiology in a reference hospital in San Luis Potosí, México.
Methods: This is an observational, descriptive, longitudinal and prospective study, the patients were recruited on a 18-month period from April 2011 to October 2012.
Results: We identify 21 cases, 11 (55%) men and 10 (45%) women. The mean age was 43.85 years (range: 19 to 79 years). A total of 9 (42%) patients did not have a history of infection, 6 patients (28%) had gastrointestinal infection, 5 patients (23%) had a prior respiratory infection and one patient had H1N1 influenza vaccination. The time between infection and symptoms appearance was on average 10.5 days with gastrointestinal infection and 17.6 with respiratory infection. The clinical presentation was an ascending weakness involving the 4 extremities in 90% of the patients, paresthesia and dysesthesia in 38%, dysphonia in 38%, dyspnea in 33.3% and dysphagia in 33.3%. Furthermore, 61% of the patients presented with the classical acute inflammatory demyelinating polyneuropathy (AIDP) variant, 14.28% Miller Fisher syndrome, 14.28% acute motor and sensory axonal neuropathy (AMSAN), 4.76% acute motor axonal neuropathy (AMAN) and 4.76% pandisautonomic variant. In all, 19% of the patients received medical support only, 57% intravenous immunoglobulin and 23% was treated with plasmapheresis. A total of 52% of patients required mechanical ventilation with a mean hospital stay of 14.3 days. In all, 77% of the patients who presented with disautonomia in the emergency room, required mechanical ventilation.
Conclusion: We identified some differences with previous published literature. We found a prolonged hospital stay and a high frequency of patients requiring mechanical ventilation. It was also found an important relationship between dysautonomia and the requirement of mechanical ventilation. It is necessary to improve risk prediction in patients with GBS.


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