Arunagiri, R (2011) A Study of clinical and electrophysiological profile of Guillain-Barr Syndrome. Masters thesis, Madurai Medical College, Madurai.
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Abstract
Guillain Barre Syndrome (GBS) or Acute Polyradiculoneuritis is an acute, diffuse post infective disorder of the nervous system involving the spinal roots, the peripheral nerves and occasionally the cranial nerves. The aetiology is thought to be widespread demyelination of the spinal roots and the peripheral nerves due to a cross reaction between myelin and unconfirmed agents like viruses. GBS is a syndrome of acute areflexic motor paralysis. The disorder is heterogeneous and diverse in its antecedent events, clinical presentations and natural course, such that making the diagnosis is a challenge for most neurologists. Although GBS often has a benign prognosis, 7% of patients die and further 16% suffer residual disability. The modalities of treatment of GBS are physiotherapy, supportive treatment, ventilator management, plasma exchange and of late intravenous immunoglobulins. This thesis was undertaken to study the clinical and epidemiological profile as well as electrophysiological features of Guillain Barre Syndrome and to know the incidence of various variants in the studied population. AIM OF THE STUDY: To study the epidemiological features of GBS, To analyze the clinical profile of GBS, To evaluate electrophysiological features of GBS, To know about various G B variants in studied population. CONCLUSIONS: 1. GBS occurs in all age groups with a greater incidence in the older age group above 50 years. However age did not have any correlation with prognosis. 2. GBS affects both sexes; however males were affected more than females in the ratio of 7:3 in this study. 3. Nearly 1/2 of patients reported a definite antecedent event prior to onset of GBS. 4. Onset of GBS is heralded by both motor and sensory symptoms However; objective sensory deficit is seen in very few patients. 5. Ascending type of paralysis was most commonly seen in our study. 6. Progression to maximal motor deficit occurred within 3 days in 90% of patients. Progression of muscle weakness beyond 4 weeks is not seen. 7. Cranial nerve dysfunction occurred in 56% of patients in GBS. Facial nerve was most commonly involved. 8. Autonomic dysfunction occurred in 1/4th patients. 9. Respiratory failure occurred in 1/3rd of patients in GBS. 10. Albuminocytological dissociation was seen in majority of patients of GBS after 1 week. However, CSF protein level has no prognostic value.CSF protein level may be normal in some cases initially, repeat studies may show elevated protein levels. 11. Rapid progression from onset to peak paralysis, prolonged duration of peak paralysis, need for ventilatory support and severity of paralysis were the factors associated with poor recovery from the illness. 12. Demyelinating with secondary axonal neuropathic pattern (Mixed pattern) was the commonest electro physiological abnormality in this study. 13. Conduction abnormalities were not similar in all the nerves studied. Varying severity of involvement may occur in nerves due to multi focal demyelination 14. Mortality in GBS was 6% in our study. 15. AIDP was the commonest subtype in studied population, followed by AMAN variant.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Guillain-Barr Syndrome ; clinical and electrophysiological profile. |
| Subjects: | MEDICAL > Neurology |
| Depositing User: | Kambaraman B |
| Date Deposited: | 03 Jul 2017 08:26 |
| Last Modified: | 03 Jul 2017 08:26 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/792 |
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