Clinical Characteristics and Predictors of Short-Term Outcome in Mexican Adult Patients with Guillain-Barré Syndrome

• Published in: Neurology India 2021-01, Vol.69 (1), p.107-114
• Main Authors: Ruiz-Sandoval, Jose, Salvatella-Gutiérrez, Ana, López-Valencia, GermáN, Chiquete, Erwin, Ruiz-Herrera, Vida, Pérez-Gómez, HéCtor, Adrián, Miranda-GarcíA, Jiménez-Ruiz, Amado, Rodríguez-Hinojosa, Jorge, Quintero-Reyes, ÁNgeles, González-Jaime, José, Cabrera, Teresita VillaseòOr
• Format: Article
• Language: English
• Subjects: Care and treatment; Demographic aspects; Guillain-Barre syndrome; Patient outcomes
• ISSN: 0028-3886; 1998-4022
• DOI: 10.4103/0028-3886.310063

Background: Information regarding the clinical presentation and outcome of Guillain-Barré Syndrome (GBS) in adults from Latin America is limited. Objective: To identify clinical characteristics and short-term outcome predictors in adult Mexican patients with GBS. Patients and Methods: We included adult patients with clinical and electrophysiological data with confirmed GBS, admitted to a tertiary hospital in Western Mexico, from January 2002 to February 2011. A good outcome at hospital discharge was considered if patients had a Hughes score of 0–2 and at 3 and 6 months, a Hughes score of 0–1. Results: A total of 115 patients were analyzed (68% men, mean age 44 years old, range 18–84). Previous infection occurred in 63% of cases. Descendent pattern of weakness was observed in 40 (35%) patients. GBS subtypes were: acute motor axonal neuropathy in 31%, acute inflammatory demyelinating polyneuropathy in 29%, sensory axonal neuropathy (AMSAN) in 18%, and equivocal in 22%. A total of 73 (63%) patients received induction therapy: 50 (68%) received plasmapheresis and 13 (18%) received intravenous immunoglobulin (IVIG). In-hospital mortality occurred in 14 (12%) patients. Early gait complaints and emergency room admission with mild Hughes score (0-2) were predictors for a good outcome at hospital discharge (P < 0.05); meanwhile, age >75 years; dysarthria and higher Hughes score were associated with a poor outcome(P < 0.05). Conclusions: Axonal pattern, motor involvement, and the descendent pattern of presentation were the main clinical GBS findings in our cohort. Higher Hughes scale scores at hospital admission were a strong predictor for a bad outcome at hospital discharge and short-term follow-up, independently of treatment type or in-hospital management. GBS in Mexico still carries considerable mortality.