Epidemiology and Clinical Features of Guillain-Barre Syndrome in Isfahan, Iran

Document Type : Original Article

Authors
Behnaz Ansari 1
Keivan Basiri 1
Yeganeh Derakhshan 2
Farzaneh Kadkhodaei 2
Ali Asghar Okhovat 3
1 Isfahan Neurosciences Research Center, Alzahra Research Institute; Department of Neurology, Isfahan University of Medical Sciences, Isfahan, Iran
2 Isfahan Neurosciences Research Center, Alzahra Research Institute, Isfahan University of Medical Sciences, Iran
3 Sina Trauma and Surgery Research Center; Department of Neurology, Tehran University of Medical Sciences, Sina Hospital, Tehran, Iran
Abstract
Background: Guillain-Barre syndrome (GBS) is an immune-mediated peripheral neuropathy. We compared clinical, laboratory characteristics, and disease course of GBS subtypes in a large group of Iranian patients in Isfahan. Materials and Methods: We collected data from patients who were admitted to Alzahra referral university Hospital, Isfahan, Iran with a diagnosis of GBS. In this population-based cross-sectional research, characteristic of 388 cases with GBS between 2010 and 2015 were studied. Results: The current study recruited 388 patients with GBS including 241 males (62.1%) and 147 females (37.9%) with a mean age of 42.78 ± 21.34. Patients with polyradiculopathy had the highest mean age of 55.12 ± 20.59 years, whereas the least age was seen in acute motor axonal neuropathy (AMAN) with the mean of 36.30 ± 18.71 years. The frequency of GBS witnessed the highest frequency in spring with 113 cases (29.1%) and winter with 101 cases (26%). Patients' electrodiagnostic findings indicated that the highest frequency pertained to AMSAN with 93 cases (24%), whereas the least frequent diagnosis was acute Polyradiculopathy with 8 cases (2.1%). Most of the patients did not have any infections (53.6%) and among patients with infections, AMSAN had the highest frequency (22.9%) and finally, patients with AMSAN and AMAN had a higher length of stay. Conclusion: The study demonstrated incidence, sex distribution, preceding infection, and surgery similar to previous studies. However, our data differs from a study in Tehran that showed acute inflammatory demyelinating polyradiculoneuropathy is more prevalent than other types and we found a seasonal preponderance in cold months, particularly in axonal types.

Keywords

1.
Hughes RA, Rees JH. Clinical and epidemiologic features of Guillain-Barré syndrome. J Infect Dis 1997;176 Suppl 2:S92-8.  Back to cited text no. 1
[PUBMED]    
2.
Asbury AK, Arnason BG, Karp HR, McFarlin DE. Criteria for diagnosis of Guillain Barre syndrome. Ann Neurol 1978;3:565-6.  Back to cited text no. 2
    
3.
Govoni V, Granieri E. Epidemiology of the Guillain-Barre syndrome. Curr Opin Neurol 2001;14:605-13.  Back to cited text no. 3
[PUBMED]    
4.
Yuki N, Hartung HP. Guillain-Barré syndrome. N Engl J Med 2012;366:2294.  Back to cited text no. 4
[PUBMED]    
5.
Sejvar JJ, Baughman AL, Wise M, Morgan OW. Population incidence of Guillain-Barré syndrome: A systematic review and meta-analysis. Neuroepidemiology 2011;36:123-33.  Back to cited text no. 5
[PUBMED]    
6.
Morris AM, Elliott EJ, D'Souza RM, Antony J, Kennett M, Longbottom H, et al. Acute flaccid paralysis in Australian children. J Paediatr Child Health 2003;39:22-6.  Back to cited text no. 6
    
7.
Carroll JE, Jedziniak M, Guggenheim MA. Guillain-Barré syndrome. Another cause of the “floppy infant”. Am J Dis Child 1977;131:699-700.  Back to cited text no. 7
[PUBMED]    
8.
Buchwald B, de Baets M, Luijckx GJ, Toyka KV. Neonatal Guillain-Barré syndrome: Blocking antibodies transmitted from mother to child. Neurology 1999;53:1246-53.  Back to cited text no. 8
[PUBMED]    
9.
Hughes RA, Cornblath DR. Guillain-Barré syndrome. Lancet 2005;366:1653-66.  Back to cited text no. 9
[PUBMED]    
10.
Burns TM. Guillain-Barré syndrome. Semin Neurol 2008;28:152-67.  Back to cited text no. 10
[PUBMED]    
11.
Asbury AK, Cornblath DR. Assessment of current diagnostic criteria for Guillain-Barré syndrome. Ann Neurol 1990;27:S21-4.  Back to cited text no. 11
[PUBMED]    
12.
Kleyweg RP, Van der Meche FG. Treatment related fluctuations in Guillain Barré syndrome after high dose immunoglobulins or plasma exchange. J Neurol Neurosurg Psychiatry 1991;54:957-60.  Back to cited text no. 12
    
13.
Patwa HS, Chaudhry V, Katzberg H, Rae-Grant AD, So YT. Evidence-based guideline: Intravenous immunoglobulin in the treatment of neuromuscular disorders: Report of the therapeutics and technology assessment subcommittee of the American Academy of Neurology. Neurology 2012;78:1009-15.  Back to cited text no. 13
[PUBMED]    
14.
Fokke C, van den Berg B, Drenthen J, Walgaard C, van Doorn PA, Jacobs BC, et al. Diagnosis of Guillain-Barré syndrome and validation of Brighton criteria. Brain 2014;137:33-43.  Back to cited text no. 14
    
15.
Frankle RT. Nutrition education in the medical school curriculum: A proposal for action: A curriculum design. Am J Clin Nutr 1976;29:105-9.  Back to cited text no. 15
[PUBMED]    
16.
Dourado ME, Félix RH, da Silva WK, Queiroz JW, Jeronimo SM. Clinical characteristics of Guillain-Barré syndrome in a tropical country: A Brazilian experience. Acta Neurol Scand 2012;125:47-53.  Back to cited text no. 16
    
17.
Blaser MJ, Olivares A, Taylor DN, Cornblath DR, McKhann GM. Campylobacter serology in patients with Chinese paralytic syndrome. Lancet 1991;338:308.  Back to cited text no. 17
    
18.
Verity C, Stellitano L, Winstone AM, Andrews N, Stowe J, Miller E, et al. Guillain-Barré syndrome and H1N1 influenza vaccine in UK children. Lancet 2011;378:1545-6.  Back to cited text no. 18
    
19.
Bardage C, Persson I, Ortqvist A, Bergman U, Ludvigsson JF, Granath F, et al. Neurological and autoimmune disorders after vaccination against pandemic influenza A (H1N1) with a monovalent adjuvanted vaccine: Population based cohort study in Stockholm, Sweden. BMJ 2011;343:d5956.  Back to cited text no. 19
    
20.
Lee GM, Greene SK, Weintraub ES, Baggs J, Kulldorff M, Fireman BH, et al. H1N1 and seasonal influenza vaccine safety in the vaccine safety Datalink project. Am J Prev Med 2011;41:121-8.  Back to cited text no. 20
[PUBMED]    
21.
Cao-Lormeau VM, Blake A, Mons S, Lastere S, Roche C, Vanhomwegen J, et al. Guillain-Barré syndrome outbreak associated with Zika virus infection in French Polynesia: A case-control study. Lancet 2016;387:1531-9.  Back to cited text no. 21
    
22.
Nelson L, Gormley R, Riddle MS, Tribble DR, Porter CK. The epidemiology of Guillain-Barré syndrome in U.S. military personnel: A case-control study. BMC Res Notes 2009;2:171.  Back to cited text no. 22
    
23.
Hui AC, Chow KM, Tang AS, Fu M, Kay R, Wong KS, et al. Electrophysiological, clinical and epidemiological study of Guillain-Barre syndrome in Hong Kong Chinese. J Clin Neurosci 2005;12:134-6.  Back to cited text no. 23
    
24.
Bahou YG, Biary N, al Deeb S. Guillain-Barre syndrome: A series observed at Riyadh armed forces hospital January 1984 – January 1994. J Neurol 1996;243:147-52.  Back to cited text no. 24
[PUBMED]    
25.
Lin JJ, Hsia SH, Wang HS, Lyu RK, Chou ML, Hung PC, et al. Clinical variants of Guillain-Barré syndrome in children. Pediatr Neurol 2012;47:91-6.  Back to cited text no. 25
[PUBMED]    
26.
Hadden RD, Cornblath DR, Hughes RA, Zielasek J, Hartung HP, Toyka KV, et al. Electrophysiological classification of Guillain-Barré syndrome: Clinical associations and outcome. Plasma Exchange/Sandoglobulin Guillain-Barré Syndrome Trial Group. Ann Neurol 1998;44:780-8.  Back to cited text no. 26
[PUBMED]    
27.
Nagarajan V, Al-Shubaili A. Clinical and neurophysiological pattern of Guillain-Barré syndrome in Kuwait. Med Princ Pract 2006;15:120-5.  Back to cited text no. 27
[PUBMED]    
28.
Shafqat S, Khealani BA, Awan F, Abedin SE. Guillain-Barré syndrome in Pakistan: Similarity of demyelinating and axonal variants. Eur J Neurol 2006;13:662-5.  Back to cited text no. 28
[PUBMED]    
29.
Gupta D, Nair M, Baheti NN, Sarma PS, Kuruvilla A, Diplomate-American Board, et al. Electrodiagnostic and clinical aspects of Guillain-Barré syndrome: An analysis of 142 cases. J Clin Neuromuscul Dis 2008;10:42-51.  Back to cited text no. 29
    
30.
Yadegari S, Kazemi N, Nafissi S. Clinical and electrophysiological features of Guillain-Barré syndrome in Iran. J Clin Neurosci 2014;21:1554-7.  Back to cited text no. 30
[PUBMED]    
31.
Nagasawa K, Kuwabara S, Misawa S, Fujii K, Tanabe Y, Yuki N, et al. Electrophysiological subtypes and prognosis of childhood Guillain-Barré Syndrome in Japan. Muscle Nerve 2006;33:766-70.  Back to cited text no. 31
[PUBMED]    
32.
Ropper AH, Shahani BT. Pain in Guillain-Barré syndrome. Arch Neurol 1984;41:511-4.  Back to cited text no. 32
[PUBMED]    
33.
Hao Q, Saida T, Yoshino H, Kuroki S, Nukina M, Saida K, et al. Anti-galNAc-GD1a antibody-associated Guillain-Barré syndrome with a predominantly distal weakness without cranial nerve impairment and sensory disturbance. Ann Neurol 1999;45:758-68.  Back to cited text no. 33
    
34.
Nachamkin I, Allos BM, Ho T. Campylobacter species and Guillain-Barré syndrome. Clin Microbiol Rev 1998;11:555-67.  Back to cited text no. 34
[PUBMED]   
Advanced Biomedical Research
Volume 2018, May
May 2018
Pages 1-5