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Alzuhaily H, Khashaneh E, Albkhetan S, Abbas F. An unusual occurrence of opsoclonus and liver enzymes elevation in a patient with acute motor and sensory axonal neuropathy subtype of Guillain-Barré syndrome. BMC Neurol 2022; 22:102. [PMID: 35303829 PMCID: PMC8932169 DOI: 10.1186/s12883-022-02599-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 02/23/2022] [Indexed: 11/13/2022] Open
Abstract
Background Acute motor and sensory axonal neuropathy (AMSAN) is a subtype of Guillain-Barré syndrome (GBS) differentiated by nerve conduction studies (NCS) and characterized by symmetric ascending paralysis often involving respiratory muscles. While opsoclonus, which is involuntary chaotic rapid eye movements, is not a common manifestation of GBS. Moreover, little published data are available on the relation between liver enzymes elevation and GBS. Case presentation A 42-year-old man presented to Al Mouwassat University Hospital with weakness in all limbs and dyspnea. Examination showed an elevated respiratory rate, hyporeflexia, and decreased strength of upper and lower limbs. Analysis of cerebrospinal fluid revealed an albuminocyto-dissociation suggesting the diagnosis of GBS and subsequent plasmapheresis. NCS confirmed a diagnosis of AMSAN. Elevation in liver enzymes was noticed prompting further exploration with no positive findings. Despite treatment efforts, the patient developed severe dyspnea, deterioration in cognitive abilities, and opsoclonus with a normal brain MRI. Unfortunately, he developed respiratory failure which lead to his death. Conclusion In this case, we highlight the occurrence of opsoclonus which is a rarely-encountered manifestation of GBS, in addition to an unexplained elevated liver enzyme, the thing that could contribute to larger research to further comprehend the pathophysiology of GBS. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-022-02599-0.
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Affiliation(s)
| | - Eman Khashaneh
- Department of Neurology, Damascus University, Damascus, Syria
| | | | - Fatima Abbas
- Department of Internal Medicine, Damascus University, Damascus, Syria
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Yao J, Liu Y, Liu S, Lu Z. Regional Differences of Guillain-Barré Syndrome in China: From South to North. Front Aging Neurosci 2022; 14:831890. [PMID: 35177978 PMCID: PMC8845027 DOI: 10.3389/fnagi.2022.831890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 01/03/2022] [Indexed: 11/13/2022] Open
Abstract
Background The epidemiological features of Guillain-Barré syndrome (GBS) were different in different areas; a comparison of the disease was needed to identify the variation and prognosis. We compare the epidemiological features of GBS in different areas in China. Method A total of 1,191 patients were included. Information was collected in patients diagnosed with GBS and its variants in middle and south China, and then retrospectively reviewed. The patients were divided into four different regions: East China (n = 441), Center China (n = 566), South China (n = 77), and Southwest China (n = 107). These subregions are mainly divided by climate and geographical location. These data were compared with data from a study in East China (Shandong, n = 150) and Northeast China (Changchun, n = 750). Results Patients from the south and southwest China were younger than other regions (P = 0.000). A summer peak and an autumn peak were found in northern China, but more patients in winter and spring days in other areas (P = 0.000). Upper respiratory tract infection (URTI) was the preceding event of GBS patients in all regions but rarer in central China (P = 0.001). The proportion of axonal subtype was higher in central and southwest China than in other regions (P = 0.001). Patients in southwest China were more served at nadir and have the longest hospital stay (P = 0.003 and P = 0.000). Conclusion The difference between seasonal variation and preceding events was found in different regions in China; clinical features differ among regions in China.
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Zheng P, Tian DC, Xiu Y, Wang Y, Shi FD. Incidence of Guillain-Barré syndrome (GBS) in China: A national population-based study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 18:100302. [PMID: 35024648 DOI: 10.1016/j.lanwpc.2021.100302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 09/18/2021] [Accepted: 09/23/2021] [Indexed: 12/17/2022]
Abstract
Background Guillain-Barré syndrome (GBS) is the most prevalent acute autoimmune polyneuropathy, however, the incidence of GBS across China remains undetermined. We conducted the first nationwide study to extrapolate the incidence and mortality rates of GBS across all age groups at a national scale. Methods This study analyzed patient metrics from the National Hospital Quality Monitoring System, a comprehensive administrative database of which incorporate all 1665 tertiary hospitals in mainland China. For all study patients the "Medical Record Homepage" encompasses 346 distinct variables such as demographic characteristics, diagnoses, procedures, expenses, etc., that are systematically recorded from these hospitals by standard protocol. All GBS diagnoses adhered to the National Institute of Neurologic and Communicative Disorders and Stroke (NINCDS) diagnostic criteria and were identified with ICD-10 code (G61•0). Findings From 2016 to 2019, 75,548 hospital admissions for 38,861 GBS patients were identified. The age- and sex-adjusted incidence per 100,000 person-years is 0·698 (95% confidence interval [CI], 0·691-0·705), 0·233(0·225-0·242) in children and 0·829(0·820-0·837) in adults. The male-to-female ratio is 1·49. Peak disease onset was detected in the 70-74 years age group with an incidence of 1·806/100, 000 (95% CI, 1·741-1·870). Recognizable GBS distribution patterns were recognized in the southeastern coastal areas, where the cases of GBS were concentrated in the summer and autumn seasons. Prevalent comorbidities include hypertension (28·8%) and stroke (14·3%). The median length of hospitalization was 13·0 (8·0-18·0) days with a median hospitalization cost of $2371·60 ($1281·80-5463·60). Covering 69·9% of study patients, the Basic Medical Insurance was the most common payment mechanism. From 2016-2019, 426 adults and 13 children died in this study pool, with a hospital mortality rate of 11·2 per 1,000 person-years. Interpretation For the first time, we obtained a national incidence for GBS at 0·233 in children and 0·829 in adults per 100,000 in China. A differential spatiotemporal incidence is presented most southeast coastal areas in the summer and autumn seasons. Funding National Science Foundation of China (91949208, 91642205, and 81830038); Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing.
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Affiliation(s)
- Pei Zheng
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China.,Department of Neurology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - De-Cai Tian
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Yuwen Xiu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Yongjun Wang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Fu-Dong Shi
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China.,Department of Neurology, Tianjin Medical University General Hospital, Tianjin 300052, China
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4
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Wen P, Wang L, Liu H, Gong L, Ji H, Wu H, Chu W. Risk factors for the severity of Guillain-Barré syndrome and predictors of short-term prognosis of severe Guillain-Barré syndrome. Sci Rep 2021; 11:11578. [PMID: 34079013 PMCID: PMC8172857 DOI: 10.1038/s41598-021-91132-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 05/17/2021] [Indexed: 01/28/2023] Open
Abstract
Guillain-Barré syndrome (GBS) is a neurological disorder characterized by paralysis. Identifying the severity, appropriate therapeutic method, and prognosis of GBS at an early stage is highly important. This study aimed to investigate the modifiable risk factors for the severity of GBS and consequent need for mechanical ventilation (MV) and to identify clinical predictive factors for poor short-term outcomes of severe GBS. 155 GBS patients who were admitted to the Affiliated Yantai Yuhuangding Hospital of Qingdao University during 2014–2020 were enrolled. Demographic, clinical, therapeutic and evolutionary data were collected and were then analyzed using univariate and multivariate regression analyses. Our analytic data demonstrated that the significant clinical predictors of severe GBS were recent history of surgery, older age, cranial nerve impairment, and elevated levels of liver enzymes (p < 0.05). Furthermore, autonomic dysfunction, lower Medical Research Council (MRC) score at nadir, and elevated levels of liver enzymes were significantly associated with MV for severe GBS (p < 0.05), and lower MRC score at nadir and autonomic dysfunction remained significant predictors of MV in severe GBS (p < 0.05). Lastly, recent history of surgery, lower MRC score at admission and at nadir, requirement for MV, and pneumonia during hospitalization were significantly associated with the short-term outcome of severe GBS and that lower MRC score at admission and need for MV were confirmed to be predictors of poor short-term prognosis (p < 0.05). Of note, this study suggested that recent history of surgery is a predictor of severity in GBS patients and is associated with the poor short-term prognosis of severe GBS.
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Affiliation(s)
- Puyuan Wen
- Department of Neurology, The affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 264000, Shandong, People's Republic of China
| | - Lisha Wang
- Department of Neurology, The affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 264000, Shandong, People's Republic of China
| | - Hong Liu
- Department of Neurology, The affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 264000, Shandong, People's Republic of China
| | - Li Gong
- Department of Neurology, The affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 264000, Shandong, People's Republic of China
| | - Han Ji
- Department of Neurology, The affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 264000, Shandong, People's Republic of China
| | - Hongliang Wu
- Department of Neurology, The affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 264000, Shandong, People's Republic of China.
| | - Wenzheng Chu
- Department of Neurology, The affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 264000, Shandong, People's Republic of China.
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5
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Stojanov A, Berisavac I, Bozovic I, Arsenijevic M, Lukic‐Rajic S, Petrovic M, Stojiljkovic‐Tamas O, Jovin Z, Djordjevic G, Jovanovic D, Stojanovic M, Martic V, Basta I, Peric S. Incidence and mortality rates of
Guillain‐Barré
syndrome in Serbia. J Peripher Nerv Syst 2020; 25:350-355. [DOI: 10.1111/jns.12412] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/25/2020] [Accepted: 08/27/2020] [Indexed: 01/03/2023]
Affiliation(s)
| | - Ivana Berisavac
- Neurology Clinic Clinical Center of Serbia Belgrade Serbia
- Faculty of Medicine University of Belgrade Belgrade Serbia
| | - Ivo Bozovic
- Neurology Clinic Clinical Center of Serbia Belgrade Serbia
| | | | | | | | | | - Zita Jovin
- Neurology Clinic Clinical Center of Vojvodina Novi Sad Serbia
| | - Gordana Djordjevic
- Neurology Clinic Clinical Center Nis Nis Serbia
- Faculty of Medicine University of Nis Nis Serbia
| | - Dejana Jovanovic
- Neurology Clinic Clinical Center of Serbia Belgrade Serbia
- Faculty of Medicine University of Belgrade Belgrade Serbia
| | | | - Vesna Martic
- Neurology Clinic Military Medical Academy Belgrade Serbia
| | - Ivana Basta
- Neurology Clinic Clinical Center of Serbia Belgrade Serbia
- Faculty of Medicine University of Belgrade Belgrade Serbia
| | - Stojan Peric
- Neurology Clinic Clinical Center of Serbia Belgrade Serbia
- Faculty of Medicine University of Belgrade Belgrade Serbia
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6
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Benedetti L, Briani C, Beronio A, Massa F, Giorli E, Sani C, Delia P, Artioli S, Sormani MP, Mannironi A, Tartaglione A, Mancardi GL. Increased incidence of axonal Guillain‐Barré syndrome in La Spezia area of Italy: A 13‐year follow‐up study. J Peripher Nerv Syst 2019. [DOI: 10.1111/jns.12292 10.1111/jns.12292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Luana Benedetti
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child HealthUniversity of Genova, IRCCS Policlinico San Martino Genoa Italy
| | - Chiara Briani
- Department of NeurosciencesUniversity of Padova Padova Italy
| | | | - Federico Massa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child HealthUniversity of Genova, IRCCS Policlinico San Martino Genoa Italy
| | - Elisa Giorli
- Department of NeurologySant'Andrea Hospital La Spezia Italy
| | - Cinzia Sani
- U.O Intensive Care UnitSant'Andrea Hospital La Spezia Italy
| | - Paola Delia
- Transfusion CenterSant' Andrea Hospital La Spezia Italy
| | | | | | | | | | - Giovanni L. Mancardi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child HealthUniversity of Genova, IRCCS Policlinico San Martino Genoa Italy
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7
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Benedetti L, Briani C, Beronio A, Massa F, Giorli E, Sani C, Delia P, Artioli S, Sormani MP, Mannironi A, Tartaglione A, Mancardi GL. Increased incidence of axonal Guillain-Barré syndrome in La Spezia area of Italy: A 13-year follow-up study. J Peripher Nerv Syst 2018; 24:80-86. [PMID: 30421471 DOI: 10.1111/jns.12292] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 10/26/2018] [Accepted: 10/26/2018] [Indexed: 12/13/2022]
Abstract
Guillain-Barré syndrome (GBS) is an acute immune-mediated polyradiculoneuropathy with a worldwide incidence of 0.81-1.89 per 100 000 person-years. In Europe and North America only 5% of patients with GBS have axonal subtypes, which in South America and Asia account for 30%-47% of cases. The aim of our study is to assess the annual incidence and clinical features of GBS in La Spezia area in Italy. A retrospective (from 1 January 2003 to 31 December 2011) followed by a prospective (from 1 January 2012 to 31 December 2015) analysis was carried out on patients admitted to La Spezia hospital who fulfilled the GBS diagnostic criteria. A total of 86 patients (58 men), mean age of 62.7 years (range 21-90), were included. The mean annual incidence rate was 3/100 000 (range: 0.9/100 000-5.37/100 000) significantly higher than the European incidence (P < 0.001). Forty-seven percent were classified as acute inflammatory demyelinating polyradiculoneuropathy (AIDP), 35% as acute motor and motor-sensory axonal neuropathy (AMAN-AMSAN), 13% as variant forms, and 5% were not defined. AIDP was most common in "Golfo dei Poeti" (50%) and "Val di Magra" (63.2%), whereas AMAN/AMSAN prevailed in "Val di Vara" (63.6%) and "Riviera Spezzina" (62.5%) (P = 0.024). In La Spezia area GBS incidence (especially the AMAN subtype) is significantly higher than the incidence reported in Europe. AIDP predominates in the eastern area whereas AMAN/AMSAN in the western, with a significantly different incidence rate (P = 0.003). Prospective studies to assess possible predisposing environmental factors are needed.
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Affiliation(s)
- Luana Benedetti
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Policlinico San Martino, Genoa, Italy
| | - Chiara Briani
- Department of Neurosciences, University of Padova, Padova, Italy
| | | | - Federico Massa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Policlinico San Martino, Genoa, Italy
| | - Elisa Giorli
- Department of Neurology, Sant'Andrea Hospital, La Spezia, Italy
| | - Cinzia Sani
- U.O Intensive Care Unit, Sant'Andrea Hospital, La Spezia, Italy
| | - Paola Delia
- Transfusion Center, Sant' Andrea Hospital, La Spezia, Italy
| | - Stefania Artioli
- Infectious Disease Unit, Sant' Andrea Hospital, La Spezia, Italy
| | - Maria P Sormani
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | | | | | - Giovanni L Mancardi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, IRCCS Policlinico San Martino, Genoa, Italy
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8
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Abstract
Neuromuscular disorders as a group are linked by anatomy with significant differences in pathogenetic mechanisms, clinical expression, and time course of disease. Each neuromuscular disease is relatively uncommon, yet causes a significant burden of disease socioeconomically. Epidemiologic studies in different global regions have demonstrated certain neuromuscular diseases have increased incidence and prevalence rates over time. Understanding differences in global epidemiologic trends will aid clinical research and policies focused on prevention of disease. There is a critical need to understand the global impact of neuromuscular diseases using metrics currently established for communicable and noncommunicable diseases.
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Affiliation(s)
- Jaydeep M Bhatt
- Department of Neurology, New York University School of Medicine, 240 East 38th Street, 20th Floor, New York, NY 10016, USA.
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9
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Peric S, Milosevic V, Berisavac I, Stojiljkovic O, Beslac-Bumbasirevic L, Marjanovic I, Djuric V, Djordjevic G, Rajic S, Cvijanovic M, Babic M, Dominovic A, Vujovic B, Cukic M, Petrovic M, Toncev G, Komatina N, Martic V, Lavrnic D. Clinical and epidemiological features of Guillain-Barré syndrome in the Western Balkans. J Peripher Nerv Syst 2015; 19:317-21. [PMID: 25582576 DOI: 10.1111/jns.12096] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 10/02/2014] [Accepted: 10/27/2014] [Indexed: 12/11/2022]
Abstract
The aim of this study was to define features of Guillain-Barré syndrome in a large cohort of patients from three Western Balkans countries. Data from adult Guillain-Barré syndrome (GBS) cases from 2009 to 2013 were retrospectively obtained from all tertiary health care centers. During the 5-year period, 327 new cases of GBS were identified with a male to female ratio of 1.7 : 1. The most common GBS variants were demyelinating (65%) and axonal (12%). At nadir 45% of patients were chair-bound, confined to bed, or required assisted ventilation, while 5% died. The crude incidence of GBS in Serbia and Montenegro was 0.93 per 100,000 population, and age-adjusted incidence according to the world standard population was 0.86 per 100,000. Incidence was particularly high in 50- to 80-year-old men. Statistically significant seasonal variations of GBS were not observed. This study of patients with GBS in the Western Balkans allows us to prepare the health system better and to improve the management of patients. This study also opens opportunities for international collaboration and for taking part in the multinational studies on GBS.
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Affiliation(s)
- Stojan Peric
- Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
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10
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Benedetti MD, Pugliatti M, D''Alessandro R, Beghi E, Chiò A, Logroscino G, Filippini G, Galeotti F, Massari M, Santuccio C, Raschetti R. A Multicentric Prospective Incidence Study of Guillain-Barré Syndrome in Italy. The ITANG Study. Neuroepidemiology 2015; 45:90-9. [DOI: 10.1159/000438752] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Accepted: 07/10/2015] [Indexed: 11/19/2022] Open
Abstract
Background: To assess Guillain-Barré syndrome (GBS) incidence we relied on the Italian Network for the study of GBS (ITANG) established in 2010 in 7 Italian regions to analyse the association between influenza vaccination and GBS. Methods: All individuals aged ≥18 years, presenting with clinical manifestations that suggested GBS according to the universally accepted Asbury's diagnostic criteria (1990) were prospectively notified to a centralised database by ITANG neurologists over the period October 1, 2010-September 30, 2011. Through a telephone survey, 9 trained interviewers followed up the cases to diagnosis and then for 1 year since hospital discharge. Validation of case reporting was performed with the support of administrative data in 5 regions. Results: We found 365 cases fulfilling the definition for GBS or one of its variants over 19,846,068 population ≥18 years of age, yielding an annual incidence rate of 1.84 per 100,000 (95% CI 1.65-2.03), 2.30 (95% CI 1.99-2.60) in men and 1.41 (95% CI 1.18-1.64) in women. A highly significant peak of incidence was observed in February 2011 as compared to reference month (September 2011, rate ratio 3.3:1, p < 0.01). Conclusions: In Italy, GBS incidence was among the highest reported in Europe and higher than previously observed in Italian studies.
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11
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Halawa EF, Ahmed D, Nada MAF. Guillain-Barré syndrome as a prominent cause of childhood acute flaccid paralysis in post polio eradication era in Egypt. Eur J Paediatr Neurol 2011; 15:241-6. [PMID: 21169042 DOI: 10.1016/j.ejpn.2010.11.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2010] [Revised: 11/21/2010] [Accepted: 11/21/2010] [Indexed: 12/13/2022]
Abstract
Guillain-Barré syndrome often follows an antecedent gastrointestinal or respiratory illness but, in rare cases, follows vaccination. This study was conducted to identify preceding events, demographic, clinical characteristics and prognostic factors of childhood Guillain-Barré syndrome after post-poliomyelitis eradication era in Egypt. This is a prospective study of all children with GBS (no = 50) admitted to pediatric Cairo University Hospital between January 2006 and June 2007 (70.42% of all acute flaccid paralysis patients during this period). Upper respiratory infection was the most common preceding event (24%) while only 4 patients (8%) reported antecedent oral polio vaccine. Motor deficit was frequent and severe (quadriparesis in 92% and paraparesis in 8%). Autonomic dysfunction was recorded in 32% of patients. Forty two percent of patients had poor outcome with 16% deaths. Presence of severe disability on admission and on nadir, cranial nerve affection or the need for mechanical ventilator were found to be significant predictors for poor outcome.
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Affiliation(s)
- Eman F Halawa
- Department of Pediatrics, Faculty of Medicine, Cairo University, Egypt
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12
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Soysal A, Aysal F, Caliskan B, Dogan Ak P, Mutluay B, Sakalli N, Baybas S, Arpaci B. Clinico-electrophysiological findings and prognosis of Guillain-Barré syndrome--10 years' experience. Acta Neurol Scand 2011; 123:181-6. [PMID: 20497128 DOI: 10.1111/j.1600-0404.2010.01366.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To assess correlation between the prognosis and epidemiological, clinical, laboratory, electrophysiological findings in patients with Guillain-Barré syndrome (GBS). METHODS We reviewed the medical records of 104 GBS patients who were hospitalized and followed up at our outpatient clinic during October 1997-November 2007. RESULTS Guillain-Barré syndrome patients were followed up with a median period of 232 days. Full recovery or minor deficits were observed in 41% of patients in the first month, 71% in the third month, 86% in the sixth month and 92% in the first year. We found that there was a correlation between Medical Research Council (MRC) sum scores at admission, clinical subtypes, respiratory distress, interference pattern and prognosis. CONCLUSIONS Demographic, clinical and electrophysiological findings of our GBS cases were highly similar to those of the previous reports. Two of our cases were presented with preceding tuberculosis infection, which was not reported before in the literature.
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Affiliation(s)
- A Soysal
- Bakirkoy Research and Training Hospital for Psychiatry, Neurology Department, Istanbul, Turkey.
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13
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Burwen DR, Ball R, Bryan WW, Izurieta HS, La Voie L, Gibbs NA, Kliman R, Braun MM. Evaluation of Guillain-Barré Syndrome among recipients of influenza vaccine in 2000 and 2001. Am J Prev Med 2010; 39:296-304. [PMID: 20837279 DOI: 10.1016/j.amepre.2010.05.022] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2009] [Revised: 04/09/2010] [Accepted: 05/29/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND The 1976-1977 swine influenza vaccine was associated with an elevated risk of Guillain-Barré Syndrome (GBS), especially within 6 weeks after vaccination. A 2004 IOM report concluded that evidence was inadequate to accept or reject a causal relationship between subsequent influenza vaccine formulations and GBS. Studies published after the IOM report have been limited by passively reported data or lack of validation of coded diagnoses. PURPOSE To evaluate whether influenza vaccine is associated with GBS. METHODS Controlled observational study using national data from the Medicare program, which ensures a predominantly elderly population. People included had a Medicare claim for influenza vaccination during September-December in 2000 or 2001. Medical records were reviewed to classify definite, probable, or possible GBS (or not a case) using a standardized case definition. In a risk interval design, the incidence rate of GBS during Weeks 0-6 after vaccination (exposed period) was compared to Weeks 9-14 after vaccination (comparison period). Data collection occurred during 2003-2007, and analysis was conducted during 2007-2009. RESULTS Primary analysis included 22.2 million vaccinees, among whom 164 definite or probable GBS cases with onset during Weeks 0-6 or 9-14 were identified. The incidence rate ratio (IRR [95% CIs]) based on the GBS rate in the vaccine-exposed versus comparison periods, was 1.04 (0.76, 1.43) for combined years; 0.86 (0.52, 1.41) among people vaccinated in 2000; and 1.21 (0.79, 1.86) among people vaccinated in 2001. Secondary analysis additionally included 74 possible GBS cases; results were similar. CONCLUSIONS Overall, the results do not support an association between influenza vaccine receipt and GBS among the elderly for the years studied (2000-2001 and 2001-2002 formulations).
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Affiliation(s)
- Dale R Burwen
- Office of Biostatistics and Epidemiology, Center for Biologics Evaluation and Research, Food and Drug Administration, Rockville, Maryland 20852, USA.
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14
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Abstract
The inflammatory neuropathies are a large diverse group of immune-mediated neuropathies that are amenable to treatment and may be reversible. Their accurate diagnosis is essential for informing the patient of the likely course and prognosis of the disease, informing the treating physician of the appropriate therapy and informing the scientific community of the results of well-targeted, designed and performed clinical trials. With the advent of biological therapies able to manipulate the immune response more specifically, an understanding of the pathogenesis of these conditions is increasingly important. This review presents a broad overview of the pathogenesis, diagnosis and therapy of inflammatory neuropathies, concentrating on the most commonly encountered conditions.
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Affiliation(s)
- M P T Lunn
- Centre for Neuromuscular Disease and Department of Molecular Neuroscience, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK.
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15
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Epidemiology of childhood Guillan-Barre syndrome in the north west of Iran. BMC Neurol 2007; 7:22. [PMID: 17683586 PMCID: PMC1963328 DOI: 10.1186/1471-2377-7-22] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2007] [Accepted: 08/05/2007] [Indexed: 11/10/2022] Open
Abstract
Background and aims This study was carried out to investigate the incidence, annual time trend and some epidemiological and clinical features of Guillain-Barre syndrome in children in the north west of Iran. Materials and methods In this population-based cross sectional research, epidemiological and clinical features of 143 cases with Guillain-Barre syndrome between 2001 and 2006 were studied. The setting of the study was Tabriz Children Medical Centre, the major University-Hospital located in Tabriz city of the East Azarbaijan province covering whole region. Data collected included age, gender, chronological information, preceding events, functional grade of motor deficit. Results The mean age (standard deviation) of subjects was 5.4 (3.6) years. The male/female ratio was 1.3. The average annual incidence rate was 2.27 per 100 000 population of 15 years children (CI95%: 1.9–2.6). The majority of cases occurred in March, July and November and the highest proportion of the syndrome was observed in winter (29 percent, P > 0.10). Conclusion The results indicated that an unexpected high incidence of Guillain-Barre syndrome has occurred in 2003 in the region. We concluded that a monitoring and surveillance system for Guillain-Barre syndrome is essential to set up in this region.
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