A retrospective observational study of clinical and electrophysiological types of Guillain-Barre syndrome from Delhi

Objectives: To understand the demographic characteristics (age, sex and comorbidities), distribution of electrodiagnostic subtypes, and severity and prognosis of Guillain-Barre syndrome (GBS) variants. Materials and Methods: = 137) were diagnosed using the NINDS criteria. Severity and prognosis were assessed using the Hughes disability score. Electrodiagnostic variants of GBS were labelled using a nerve conduction study. Results: The patient group showed male predominance with an increased incidence with age. Antecedent infections were observed in 52 (38%) patients. Motor weakness, areflexia, and cranial nerve involvement (VII,IX,X,XI) were the most common clinical manifestations. The electrodiagnostic profiling included 96 (70%) patients with acute demyelinating polyradiculoneuropathy (AIDP), 25 (18.24%) patients of axonal forms and 16 (11%) patients of Bickerstaff Brainstem Encephalitis, Miller Fisher syndrome and paraparetic variants. Albumin cytological dissociation was documented in 61 (70%) patients out of 86 patients, which was more marked in AIDP than in other variants. The severity of GBS, using the Hughes disability score, was higher in patients with underlying diabetes mellitus. Recurrent GBS was observed in three (2%) and mortality rate was 2.91%. Conclusions: Our study showed a higher incidence of demyelination than that of axonal variants. There was more variation in albumin cytological dissociation in demyelinating subtypes than in the other variants. GBS severity was significantly higher in the patients with diabetes mellitus.