GUILLAIN-BARRE-SYNDROME IN TAIWAN - A CLINICAL-STUDY OF 167 PATIENTS

Objective-To identify clinical characteristics of various forms of Gui llain-Barre syndrome in Taiwan. Methods-The clinical and electrophysio logical data of 167 consecutive patients with Guillain-Barre syndrome admitted to Chang Gung Memorial Hospital, a general paediatric and adu lt hospital in Taiwan, were reviewed. Results-Analysis of age distribu tion disclosed a high incidence (21%) among patients under the age of 10 years. Seasonal preponderance in Spring (March to May) was found. U tilising clinical and electrophysiological data, these 167 patients wi th Guillain-Barre syndrome were subclassified; 82 (49%) had acute infl ammatory demyelinating polyradiculoneuropathy (AIDP), 32 (19%) had Fis her syndrome (FS), and six (4%) had axonal forms of Guillain-Barre syn drome. The remaining 47 (28%) patients were unclassified. Patients wit h AIDP and FS had many common clinical features, including seasonal di stribution, history of preceding illness, sensory abnormalities, crani al nerve involvement except for extraocular motor nerves, and albumino cytological dissociation on examination of CSF. Follow up study on 145 patients disclosed that 127 (87%) recovered satisfactorily 14 (10%) w ere persistently disabled, and four (3%) died during admission to hosp ital. Clinical features associated with poor outcome (persistent disab ility or death) were requirement for mechanical ventilation, a low mea n compound muscle action potential amplitude (less than or equal to 10 % of the lower limit of normal), and age greater than 40 years. Conclu sion-Guillain-Barre syndrome in Taiwan showed a peculiar age and seaso nal distribution and a high frequency of FS not seen in other series. Given that patients with AIDP and FS had many common clinical features , AIDP and FS may have similar underlying pathological mechanisms.