Biology and Medicine

Abstract

Outcome of Guilian Barre?-Syndrome Using Clinical and Electrophysiological Parameters in Three Neurology Centers?Sudan

Mahmoud H.S. Daoud, Mohmed Hussien Ahmed Mohmed*, Mohamed Khalaf Allah Saeed, Ammar El Tahir Mohamed Ahmed, Etedal Ahmed Abu Elbasher Ibrahim, Omer Eladil Abdalla Hamid Mohammed, Khalid Mohammed Ali, Muaz Abdellatif Mohammed Elsayed, Abubakr Elmotesim Abdulla Elamin, Husam Abo Obaida and Abdalrahman Abdalmagid

Background: Guillian Barre’-Syndrome (GBS) is an acute, immune mediated disorder, commonly characterized by a rapidly progressive, ascending weakness of the extremity, trunk, respiratory and facial musculature, with inconstant sensory and autonomic dysfunction. This research conducted in Sudanese patients to study the relation between the outcome in GBS and a four parameters; age of the patient, onset duration, presence of autonomic dysfunction and the electrophysiological subtypes.

Methods: A cross-sectional study involving the main three neurology centers in Sudan conducted from March to September 2020, 62 patients enrolled in the study, structured questionnaire consisted of personal data, clinical history, examination findings, management and outcome. The Hughes Functional Grading Scale (HFGS), which provides an objective measure of disability, was used to rate clinical performance at disease nadir and at 90 day from the illness.

Results: The study revealed that males and females are equally represented; the majority of patients (70%) are between 18 and 50 years. The onset of weakness was less than or equal 3 days in (33.9%) of patients, from 4 to 7 days in (41.9%), from 8 to 14 days in (11.3%) and above 14 days in (12.9%). 25 patients (40.3%) had Evidence of autonomic dysfunction. Based on the electrophysiology, (37.09%) of patients were classified as Acute Motor Axonal Neuropathy (AMAN), (29.03%) as Acute Inflammatory Demyelinating Poly neuropathy (AIDP) and (29.03%) as Acute Motor-Sensory Axonal Neuropathy (AMSAN).

Regarding the outcome, 30 patients (48.4%) fully recovered, 25 patients (40.3%) recovered with motor deficit, and 7 patients (11.3%) unfortunately died. The results showed that there was no statistically significance between different age groups, duration of onset or presence of autonomic dysfunction and the outcome after three months, P value (.21, .21, .1) respectively. The results showed that the Prognosis after three months and the mortality rate of AMAN and AMSAN subtypes were poorer than that of AIDP.

Conclusion: Axonal type of GBS found to be in nearly 2/3 patients. 40% showed clinical evidence of dysautonomia, and showed no statistical evidence with outcome, age of the patients, and onset of the disease also did not show statistically significant effect on outcome at day-90. The outcome of axonal types at day-90 was poorer than that of demyelinating form.

Published Date: 2024-01-12; Received Date: 2023-12-12