GUILLAIN-BARRE-SYNDROME - A SERIES OBSERVED AT RIYADH ARMED-FORCES HOSPITAL - JANUARY 1984 TO JANUARY 1994

A consecutive series of 47 hospitalized cases of Guillain-Barre syndro me seen over a 10-year period was analysed with respect to: (1) age an d sex; (2) antecedent events and seasonal distribution; (3) patterns o f clinical presentation; (4) CSF and neurophysiological findings; (5) results of treatment with plasma exchange; and (6) outcome. Twenty-two were children, 20 middle-aged and 5 aged; 37 were male and 10 were fe male. The most frequent antecedent event was upper respiratory tract i nfections; a seasonal peak incidence was found in winter. Clinical, CS F and neurophysiological findings concurred with those in the Western literature; 79% of the cases were severe. Plasma exchange performed wi thin the first 2 weeks of onset benefitted in the short-term outcome, i.e. improvement by 1 grade at 4 weeks, but the long-term benefit, i.e . the ability to regain independent locomotion, was questionable. Plas ma exchange helped in curtailing the time to walking unaided but had n o benefit on the duration of artificial ventilation. Factors associate d with an adverse outcome were: age over 15 years, severity of motor e lectrodiagnostic findings (especially a decreased distal CMAP amplitud e and EMG signs of acute denervation>, requirement for ventilation and slow progression (>3 weeks) to maximum deficit. After a mean follow-u p of 11 months, 55% of the patients regained independent locomotion, w hich is a comparatively low proportion.