EPIDEMIOLOGIC-STUDY OF GUILLAIN-BARRE-SYNDROME IN SOUTH EAST ENGLAND

Objectives-To determine the incidence, treatment, and outcome of Guill ain-Barre syndrome in south east England. Methods-Patients presenting with confirmed Guillain-Barre syndrome between 1 July 1993 and 30 June 1994 were recruited via a voluntary reporting scheme coordinated by t he British Neurological Surveillance Unit, hospital activity data coll ected from acute admitting hospitals within the South East and South W est Thames Regional Health Authorities, death certificates, and a cont emporary research study of Guillain-Barre syndrome and Campylobacter j ejuni infection. All patients were followed up for one year to determi ne outcome. Results-Seventy nine patients were recruited, 35 (44%) mal e, 44 (56%) female, including three children (two boys, one girl). The crude (95% confidence interval (95% CI)) annual incidence was 1.2 (0. 9-1.4) cases/100 000 population and 1.5 (1.3-1.8)/100 000 when adjuste d for undetected cases. Twenty (25%) patients required ventilation for an average (SD) of 42 (64) days. Thirty six (46%) patients received i ntravenous human immunoglobulin, five (6%) received plasma exchange, 1 1 (14%) both treatments, three (4%) steroids, and 25 (32%) no immunomo dulatory treatment. One year later, six patients (8%) had died, all of whom were older than 60, three (4%) remained bedbound or ventilator d ependent, seven (9%) were unable to walk unaided, 14 (17%) were unable to run, and 49 (62%) had made a complete or almost complete recovery. Increasing age was significantly associated with a poorer outcome at one year. Conclusions-Despite the frequent use of modern immunomodulat ory treatments Guillain-Barre syndrome still carries considerable morb idity and mortality.