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 ORIGINAL ARTICLE
Year : 2021  |  Volume : 69  |  Issue : 1  |  Page : 107--114

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


1 Department of Neurology, Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Guadalajara; Department of Neurosciences, Translational Neurosciences Institute, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Jalisco, México
2 Department of Neurology, Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Guadalajara, Jalisco, México
3 Department of Internal Medicine, Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Guadalajara, Jalisco, México
4 Department of Infectology, Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Guadalajara, Jalisco, México
5 Department of Intensive Care Unit, Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Guadalajara, Jalisco, México
6 Department of Blood Bank and Transfusional Center, Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Guadalajara, Jalisco, México
7 Department of Physical Medicine and Rehabilitation, Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Guadalajara, Jalisco, México
8 Department of Neurosciences, Translational Neurosciences Institute, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara; Department of Neuropsychology, Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Guadalajara, Jalisco, México

Correspondence Address:
Erwin Chiquete
Department of Neurology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Vasco de Quiroga 15, Tlalpan, Postal Code: 14080, Ciudad de Mexico
México
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.310063

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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.






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