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Abstract
Introduction:
Guillain-Barre’ syndrome is a rare, monophasic autoimmune neurological disorder that can be life-threatening. It mainly affects peripheral nerves. It is often characterized by symmetric ascending weakness, motor dysfunction, and occasionally can be pure sensory.
Objectives:
This study aimed to analyze the clinical features of Guillain-Barre’ syndrome i.e. most common variant, antecedent infections, comorbidities, and treatment, etc.
Besides the nerve conduction studies test performed and the most common nerves were reviewed. Additionally, diagnostic pitfalls were examined based on clinical or electrophysiological evaluations. Plasma exchange was also observed as a pitfall.
Method:
This descriptive cross-sectional study was conducted at the Neurology Departments of Hayatabad Medical Complex and Lady Reading Hospital, along with several neurophysiological diagnostic centers in Peshawar. Participants with Guillain-Barré Syndrome were recruited during their third or fourth session of Plasmapheresis.
Results:
In a study of 75 GBS patients, 57.3% were male and 42.7% female. The most common variant was AMAN (53.3%), followed by AIDP (24.0%) and AMSAN (17.3%), with rare cases of Sensory GBS, AMCBN, and SAIDP. Dysphagia occurred in 10.7%, and respiratory distress in 25.3%. Comorbidities included hypertension (13.3%) and diabetes (8.0%). Plasmapheresis was the primary treatment (92.0%), with minimal use of IVIG. Diagnosis was delayed in 36.0% and misdiagnosed in 14.7%. Antecedent infections, mainly gastrointestinal (38.7%), were found. Upper limb motor nerves were affected in 48.0%, lower limb in 84.0%, and sensory involvement in 36.0%. Mild to moderate improvement was seen in 62.7%, with respiratory compromise (12.0%) and hemodynamic effects (18.7%).
Conclusion:
Our study found that Guillain-Barré Syndrome occurred slightly more often in men than in women, with gastrointestinal and upper respiratory infections being the most frequent precursors. Early treatment significantly improved outcomes. Moreover, GBS presented significant pitfalls in diagnosis that included delayed diagnosis usually due to patient-related factors, and misdiagnosis resulting from GBS mimicry.