Patterns of Clinical Presentation and In-Hospital Outcome of Adult Patient with Guillain-Barre Syndrome

Background: Guillain Barre Syndrome (GBS) is an acute, inflammatory, immune-mediated disorder of the peripheral nervous system triggered usually by a bacterial or viral infection or other antecedent events. GBS has become the leading cause of acute flaccid paralysis with a worldwide distribution. The incidence of GBS is variable across the world with overall incidence of 0.81-1.89/100000/year and incidence increases with age. Aim of the Study: This observational study was carried out to observe the pattern of clinical presentation, electrophysiological profile, and in-hospital outcome of Guillain-Barre Syndrome (GBS). Methods: A total number of 40 GBS patients at the department of Internal medicine, Neurology and Intensive care unit (ICU) of Sylhet M.A.G Osmani Medical College Hospital, Sylhet were enrolled during the period of February 2020 to March 2021. All patients were studied in detail including history, clinical examination and investigation. Results: The age of the patients ranged from 16 to 46 years with the mean age of 30.10 ± 13.44 years. Most of the cases occurred in autumn (60.0%) and antecedent event was present in 27.5% cases. In 40% patient’s initial symptom was bipedal edema who eventually went on to develop limb weakness/paralysis after various interval. Limb weakness was initial symptoms in 50% patients where Ascending paralysis was noted in the most of the cases (90%) and rest all 4 limbs. About 30% of the cases had objective sensory disturbance in the form distortion of pain (12%) and light touch (20%). Out of 40 patients 3 were treated with IVIg and 4 patients were managed in ICU. At discharge good or favorable outcome (GBS score < 3) was in 72.5% of the study population and poor or unfavorable outcome (GBS score ≥ 3) was in 27.5%. In hospital mortality was 10% in our study. A high GBS disability score at admission, ICU admission and mechanical ventilation were the factors that significantly associated with poor in-hospital outcome in GBS (p value <0.001 and <0.004 respectively). Conclusion: A good number of patients had pedal edema as initial symptom and all in-hospital outcome was favorable.