Clinical epidemiology of Guillain-Barre syndrome in adults in Sweden 1996-97: a prospective study

We described clinical manifestations, outcomes, prognostic indicators and c linico-epidemiological subgroups for 53 adult patients with Guillain-Barre syndrome (GBS) in Sweden during the period 1996-97. These patients were ide ntified from a population of 2.8 million inhabitants and prospectively foll owed up for one year by a network of neurologists. An additional 10 cases, of whom five were adults who had not been prospectively followed up, were n ot included in the analyses. At 6 months after onset 80% of the patients co uld walk without aid, while at 1 year 46% were fully recovered, 42% had mil d residual signs or symptoms, 4% had moderate and 6% severe disabilities, a nd 2% had died. Intravenous human immunoglobulin or plasmapheresis were use d in 72% of the patients. The sum of the Medical Research Council (MRC) sco re at nadir was found as the only significant predictor for residual signs at 1 year in a multivariate model. Three subgroups, with different clinico- epidemiological characteristics, were identified by using cluster analysis. In conclusion, GBS in Sweden is frequently preceded by a respiratory infec tion, is often treated with immunomodulatory therapies, and exhibits a high recovery rate and a low fatality rate.