Guillain-Barre syndrome. Experience in a third level hospital

Introduction. Acute peripheral neuropathy represents a medical emergency. T he causes of it are diverse and plentiful. The most common cause of acute p aralytic peripheral neuropathy is the Guillain-Barre syndrome (GBS). As man y as 85% of those affected can be expected to make an excellent recovery. O bjective. To describe the principal risk factors associated, clinical manif estations, treatment, evolution and complications of 28 cases of Guillain-B arre syndrome (GBS) in the "Instituto Nacional de Ciencias Medicas y Nutric ion Salvador Zubiran". Methods. We search in our computer records all files under diagnostic of GBS, during the last ten years. We found 28 cases that were available to study. Results. Mean age was 37 years old (SD 17.2). Fif teen patients were female (54%) and 13 were male (46%). Nine patients (32%) were preceded by a superior via infection, 5 (18%) by a diarrhea illness a nd 14 patients had not a predisposing factor. The duration of symptoms befo re diagnostic has a median of 7 days (2-15). Twenty-six patients (93%) had an ascending paralysis and 18 had paresthesias (64%). The most frequent sub type was acute inflammatory-demyelinating polyneuropathy (AIDP) in 18 patie nts (64%), acute motor-sensory axonal neuropathy (AMSAN) in 5 (18%), acute motor axonal neuropathy (AMAN) in 3 (11%) and 2 patients (7%) had the Fishe r-Miller syndrome. Fifteen patients (54%) developed respiratory involvement requiring mechanical ventilation. Twenty-four patients (86%) had cerebrosp inal fluid proteins elevated. Twenty patients (72%) had a total recovery, 6 (21%) had a partial recovery and 2 had not any response (7%). Discussion. GBS is a particularly highstakes illness in that its onset is sudden and pa ralysis is frequently extreme (requiring assisted respiration), however, as many as 85% of those affected can be expected to make an excellent recover y. In our study the majority of patients (54%) develop respiratory involvem ent requiring mechanical ventilation but in this group the majority had a f avorable outcome (71%).