Subtypes and prognosis of Guillain-Barré syndrome

Abstract:

Objective：To analyze the clinical subtypes and prognosis of patients with Guillain-Barré syndrome（GBS），and to explore the clinical features and prognosis of the different variants of GBS. Methods：Patients with GBS admitted to The First Affiliated Hos－pital of Chongqing Medical University from 2006 to 2013 were collected and were divided into acute inflammatory demyelinating polyneuropathy（AIDP） group，acute motor axonal neuropathy（AMAN） group，Miller-Fisher syndrome（MFS） group，cranial nerve variants（CNV），Bickerstaff’s brainstem encephalitis overlaps with Guillain-Barre syndrome（BBE-GBS） group and unclassifiable group based on clinical features and electrophysiological findings，and patients were subdivided into two groups based on Hughes functional grading scale at nadir for different severities of GBS. One hundred and thirty-four patients were followed-up for 6 months. The clinical characteristics，prognosis of different subtypes and predictors of prognosis were analyzed. Results：There were 97 cases（57%） in AIDP group，37 cases（22%） in AMAN group，12 cases（7%） in MFS group，8 cases（5%） in CNV group，8 cases（5%） in BBE-GBS group and 8 cases（5%） in the other group. HFGS score was used to assess the prognosis at 3 and 6 months. The prognosis of AMAN and BBE-GBS group at 3 months（F=3.291，P=0.070）and 6 months（F=1.973，P=0.161）had no statistical significance. Prog－nosis of AMAN was worse than AIDP at 3 months（F=10.332，P=0.001） and 6 months（F=15.264，P=0.000） during the follow-up，with statistically significant differences. Outcome was good in both of MFS group and cranial nerve group at 6 months（HFGS≤1）. Logistic regression analysis revealed that the HFGS scores peaked at 3 points or more（P<0.000 1，OR=6.650，95%CI=2.865 to 15.023） and autonomic nerve dysfunction（P=0.0435，OR=2.820，95%CI=1.031 to 7.715） were associated with poor outcome at 6 months. Conclusion：AIDP is the main subtype of GBS. Prognosis of AMAN group and BBE-GBS group is poorer than that of AIDP group at 3 months and 6 months during follow-up. Prognosis is good in both cranial nerve group and MFS group. The critical patients and autonomic nerve dysfunction are predictors of poor prognosis at 6 months.