Abstract
The clinicoepidemiological features of Guillain-Barré syndrome (GBS) were studied using population-based information from medical records of 69 patients in South-West Stockholm, during the period from January 1973 to June 1992. The diagnoses were validated according to the National Institute of Neurological and Communicative Disorders and Stroke criteria. Mean age at onset was 43±20 years. For 46 patients, events during the 30-day period preceding clinical onset, 74% of them identified as respiratory infections, were recorded. The presence of preceding events was associated with male gender. A more rapid clinical progression was found among women. A CSF/serum albumin ratio ≥10, denervation potentials and mechanical ventilation required were associated with poor recovery or long duration of hospitalization. Reduced motor conduction velocity was more common and pronounced among older patients and with a high CSF/serum albumin ratio. These results suggest that there is clinical, electrophysiological and epidemiological heterogeneity in GBS, and that clinicoepidemiological subgroups of GBS may exist.
Sommario
I caratteri clinico-epidemiologici della sindrome di Guillain-Barré sono stati studiati impiegando le informazioni ottenibili su popolazione dai registri clinici di 69 pazienti nella regione Sud-Ovest di Stoccolma, durante il periodo dal gennaio 1973 al giugno 1992. La diagnosi è stata convalidata in accordo con i criteri del “National Institute of Neurological and Communicative Disorders and Stroke”. La età media di esordio è stata 43±20 anni. Gli eventi del periodo di 30 giorni precedenti l'esordio clinico sono stati registrati in 46 pazienti, e nel 74% di questi casi identificati come infezioni respiratorie. La presenza di questi eventi era associata con il sesso maschile. Una più rapida progressione clinica è stata osservata nelle donne. Il rapporto liquor/siero dell'albumina ≥10, potenziali di denervazione e la necessità di ventilazione meccanica sono state associate con un peggiore recupero o con un lungo periodo di ospedalizzazione. Una ridotta velocità di conduzione è risultata più comune e pronunciata tra i pazienti più anziani e con un più alto rapporto liquor/siero dell'albumina. Questi risultati suggeriscono che vi è una eterogeneità clinica, elettrofisiologica e epidemiologica nella GBS e che sottogruppi clinico-epidemiologici di GBS possono esistere.
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Financial support was obtained from the Karolinska Institute, the Swedish Multiple Sclerosis Society (NHR), the Swedish Medical Research Council, and the Carlos III Institute of Health, Madrid.
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Jiang, G.X., de Pedro-Cuesta, J., Fredrikson, S. et al. Guillain-Barré syndrome in South-West Stockholm, 1973–1991, 2. Clinical epidemiology. Ital J Neuro Sci 18, 49–53 (1997). https://doi.org/10.1007/BF02106232
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DOI: https://doi.org/10.1007/BF02106232