Objective: To study the mortality, morbidity and the role of specific therapy in Guillain-Barre' syndrome (GBS). Design: This was a prospective study. Place and Duration of Study: This study was conducted in the Department of Neurology, PIMS, Islamabad from January, 1999 to September, 2000. Subjects and Methods: Forty-eight patients with acute symmetrical flaccid motor weakness, which developed within a period of four weeks, were included. These patients were assessed at admission, discharge and after 2 and 6 months according to the modified Rankin Scale Score. Patients with sensory level and those having marked and persistent asymmetry of neurological signs were excluded from the study. Results: The modified disability score (DS) in the patients at admission was 2-5 in 2, 11, 19 and 16 patients, respectively. Respiratory failure was present in 16 patients. Six patients expired. After 2 months, 19 recovered, 10 were lost and disability was present in 13 patients. After 6 months, 20 recovered and 5 were disabled. Specific treatment was given to 23 patients, plasmapheresis was done in 10 patients, gammaglobulin given to 4 patients and both in 9 patients. In plasmapheresis group at admission DS was 4, 5 and 7 in 3 patients respectively. Three patients expired. At 2 months, 2 recovered, 3 disabled while 2 patients were lost. At 6 months, 2 recovered 1 disabled while 4 were lost. Similarly, in gammaglobulin group DS was 4 and 5 in 3 and 1 patient at admission. At 2 months, 3 recovered and 1 was disabled. In the combined group, admission DS was 4 in 1 and 5 in 8 patients. At 2 months, 3 recovered, 5 disabled and 1 patient was lost. At 6 months, 3 recovered and 2 patients were disabled. In the non- specific treatment group, DS was 2 and 3 in 2 and 11 patients at admission. At 2 months, 9 recovered and 3 were disabled while 1 was lost. At 6 months, 11 patients recovered and 2 were disabled. In the control group, at admission, DS was 4 in 8 and 5 in 4 patients. DS at discharge was 2 in 2 and 4 in 7 patients, while 3 patients expired. At 2-month, 2 recovered, DS was 4 in 1 patient while 6 were lost in the follow-up. Conclusion: Gammaglobulin was better than plasmapheresis as far as morbidity and mortality is concerned. Patients with DS 3 or less may be managed without specific treatment. In patients with DS 4 or more, treatment should be started as early as possible for better outcome.
|Number of pages||5|
|Journal||Journal of the College of Physicians and Surgeons--Pakistan : JCPSP|
|Publication status||Published - 2001|
- Disability evaluation
- Guillain - Barre' syndrome