RESUMEN
To determine the clinical and electrophysiological predictors of outcome in patients with Guillain-Barre syndrome [GBS]. This study was carried out on 24 patients [14 males and 10 females] with GBS. All patients were subjected to [1] history taking including informations about course of the disease, duration of illness and history of antecedent illness; [2] general clinical examination; [3] neurological examination including cranial nerves examination, muscle status and the degree of affection of the motor and sensory systems as well as the deep tendon reflexes. The muscle power was graded according to the Medical Research Council scale. Assessment of the functional ability by the functional ability score was done before and after treatment; [4] Electrophysiological studies including nerve conductions and electromyography. There was a significant correlation between the age of patients and the prognosis; the younger the patients, the better the prognosis. On the other hand, there was no significant correlation between the gender and the outcome. There was an inverse relationship between the time to maximal weakness and the outcome. Patients with respiratory muscle affection, sphincter disturbance, bradycardia or tachycardia, hypotension or hypertension, facial diplegia, and absent deep tendon reflexes in both upper and lower limbs had bad outcome. There was a significant correlation between the presence of muscle wasting, superficial and deep sensory affection as well as grade 2 muscle power and the bad outcome. Also, there was a significant correlation between initial functional ability score and the outcome. Electrophysiologically, there was a significant correlation between each of the distal motor latencies of the studied nerves [median, ulnar and common peroneal nerves], the mean amplitude of the compound muscle action potential on distal stimulation, and the motor conduction velocities of peripheral segments of the three studied nerves and the outcome. On the other side, there was a non-significant correlation between each of the sensory conduction velocities of peripheral segments of the studied nerves and the latencies of F-wave of both ulnar and common peroneal nerves and the outcome. Also, there was a non-significant correlation between distal motor latency, motor conduction velocity and the F-wave latency of the studied nerves. There was a significant improvement in the conduction studies in the studied nerves after 3 months of treatment. The clinical predictors of outcome in patients with GBS are the age, the mode of onset and the severity of clinical involvement. Manifest respiratory muscle affection, sphincter disturbance, marked autonomic disturbance, cranial nerve affection, marked degree of muscle wasting, severe degree of muscle weakness, absent deep tendon reflexes and the presence of sensory affection; all are associated with bad outcome. On the other hand, the electrophysiological findings can provide a prognostic value in patients with GBS. Delayed motor conduction velocity and reduced amplitude of cMAP on distal stimulation carry a bad outcome, but other measures including sensory conduction velocity, F-wave response and distal motor latency have no significant correlation with the outcome