Ganesa Pandian, D (2014) Analysis of Clinical and Investigatory Profile in the management and Outcome of Guillain – Barre Syndrome. Masters thesis, Madras Medical College, Chennai.
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Abstract
Guillain-Barre Syndrome (GBS) or Acute Inflammatory Demyelinating Polyradiculoneuropathy is an acute onset, immune-mediated demyelinating disorder of the peripheral nervous system. The aetiology is thought to be widespread demyelination of the spinal roots and the peripheral nerves due to a cross reaction between target antigen and myelin, axon or both. Typical clinical features of GBS are progressive, symmetric muscle weakness associated with absent or depressed deep tendon reflexes. The disorder is heterogeneous and diverse in its antecedent events, clinical presentations and natural course. Although GBS often has a benign prognosis, 7% of patients die and further 16% suffer from residual disability. The modalities of treatment of GBS are supportive treatment, ventilator management, plasma exchange and immunoglobulins. This study was undertaken to study the clinical and investigatory profile of Guillain Barre Syndrome in Rajiv Gandhi Govt. General hospital, Chennai- 3 and in an to attempt to correlate certain clinical and electrophysiological features with prognosis, to identify a poor outcome group in the early stages. CONCLUSIONS : 1. GBS occurs in all age groups with a greater incidence in the older age group above 40 years. However age does not have any correlation with prognosis. 2. GBS affects both sexes; however males are affected more than females in the ratio of 11:04. 3. Upto 2/3rds of patients report a definite antecedent event prior to onset of GBS. 4. Onset of GBS is heralded by sensory symptoms in the majority of patients. However, objective sensory deficit is seen in very few patients. 5. Ascending type of paralysis is most commonly seen in GBS with a predominant proximal muscle weakness. 6. Progression to maximal motor deficit occurs within 2 weeks in 90% of patients. Progression of muscle weakness beyond 4 weeks is not seen. 7. Respiratory failure occurs in l/3rd of patients in GBS. 8. Autonomic dysfunction is very common in GBS. But is has no correlation with prognosis. 9. Cranial nerve dysfunction occurs in 60% of patients in GBS. Facial nerve is most commonly involved. 10. Albuminocytological dissociation is seen in majority of patients of GBS after 1 week. However, CSF protein level has no prognostic value. 11. Rapid progression from onset to peak paralysis, prolonged duration of peak paralysis, need for ventilatory support and severity of paralysis are the factors associated with poor prognosis in GBS. 12. Nerve conduction study results consistent with axonal pattern and mixed pattern of neuropathy are associated with poor prognosis. 13. Mortality in GBS is 13%.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Analysis of Clinical and Investigatory Profile ; management and Outcome ; Guillain – Barre Syndrome. |
| Subjects: | MEDICAL > Neurology |
| Depositing User: | Kambaraman B |
| Date Deposited: | 30 Jun 2017 02:41 |
| Last Modified: | 30 Jun 2017 05:38 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/670 |
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