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Academia Mexicana de Neurología, A.C.

2005, Number 5

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Rev Mex Neuroci 2005; 6 (5)

Landry-Guillain-Barré-Strohl syndrome. A series in a reference hospital

Monroy GJ, Núñez OL

Language: Spanish
References: 84
Page: 372-383
PDF size: 101.98 Kb.


ABSTRACT

Objective. To reflect the experience with Guillain-Barré-Strohl syndrome in the Neurology Service of the Centro Médico Nacional 20 de Noviembre (CMN), in a four years period. We analyzed the general, clinical, paraclinical, therapeutic and prognostic characteristics, as well as the outcome. 25 clinical records of patients with final diagnosis of Guillain Barré attended the last four years in the Service of Neurology of the CMN were reviewed. The hospitalization due to GB represents 1.00-3.71% from the total; 18 (72%) were men and sevent (28%) women, with ages between 15-76 years with average of 44.92 years. There were 13 patients (52%) with antecedents of respiratory infections within the previous 1-8 weeks. The time from the beginning of GB to the arrival to the CMN was an average of 14.40 days with an interval of 3-65 days. Of 15 refered patients, 11 arrived within the therapeutic window (the first two weeks) (73.33%). The average of stay in Intensive Care Unit was 26.57 days with an interval of 7-61, and the stay in the service of Neurology was of 3-40 days with an average of 11.88. The initial symptoms of the patients were distal weakness of lower extremities (28%) and distal weakness in the upper limbs (20%); the main signs were arreflexia (72%) and hyporreflexia (28%), with predominance of a symmetrical upper paresia (27.27%), and affection of facial muscles in 28%. Six patients (24%) needed mechanical ventilation during 10-79 days (average of 32.83). 48% of patients presented dysautonomia, mainly severe arterial hypertension and tachicardia. On the other hand, cerebrospinal fluid analysis showed albuminocytologic dissociation in 80%; the electrophysiologic studies showed a mixed mild axonal damage and moderate demyelization in 28% of the cases. Sequelae after six months were hiporreflexia (51%) and dysestesias (24%). The most utilized treatment were intravenous inmunoglobulin and plasma exchange in 24% and 20% respectively. A linear correlation between the presence of tree or more risk factors and a greater need of hospital stay was found.


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