Guillain-Barré Syndrome in North Eastern Iran; 1999-2005

Objective

To study the clinical presentation, hospital course and outcomes of patients admitted with Guillain-Barre Syndrome (GBS) to three tertiary care hospitals in Mashhad, Iran.

Materials and Methods

The records of all patients admitted with flaccid paralysis between April 1999 and January 2005 were reviewed and those with the diagnosis of GBS were included in the study. Standard questionnaires were used to record clinical data on was recorded on a standardized questionnaire, which included patients' age, sex, antecedent infectious history, neurological signs and symptoms and ventilation requirements. The hospital course, including therapy given and the functional status of patients, was analyzed, including therapy given and the functional status of patients.

Results

Ninety-one cases of acute flaccid paralysis were admitted to the hospitals during the study period. Eighty-three cases, age range 10 months to 11 years, were later diagnosed as GBS afterwards, with an age range of 10 months to 11 years. The mean age for disease onset was 4.2 years; there were 47 boys and 34 girls, male to female ratio 1:0.7. Upper respiratory tract infection (62.6%) was the most common antecedent event, followed by gastrointestinal infections (19%), urinary tract infection (1.2%) and chicken pox (2.4%), while the remaining cases (14.8%) had no other cases (14.8%) did not have any reliable history of any preceding antecedent infections. Most patients developed GBS within one month of the preceding infection. Cranial nerve abnormalities (19.3%), autonomic dysfunction (7.2%) and respiratory failure requiring intubation (10.8%) were also common. The in-patient mortality was 2.4% (2 of 83).

Conclusion

GBS was found to occur slightly more often in male patients, majority of whom had histories of previous infection. Despite persistent disability, in-hospital mortality was low.