Clinical and neurophysiological pattern of Guillain-Barre syndrome in Kuwait

ABSTRACT

To study the clinical and neurophysiological pattern of Guillain-Barre syndrome [GBS] in Kuwait. The clinical records of consecutive GBS patients admitted to Ibn Sina Hospital, Kuwait, during a 7-year period between 1997 and 2003 were analyzed. Of the 41 cases, 77% were male. The majority of the cases presented during the winter months and a preceding infection was reported in two thirds of them. Proximal lower limb [LL] weakness was the predominant clinical presentation. Nerve conduction studies [NCS] demonstrated a demyelinating pattern in 70%, an axonal pattern in 15%, mixed type in 5% and no abnormality in the remaining 5%. The majority of the patients [73%] improved with one course of intravenous immunoglobulin [IV IG]. Mean recovery time [MRT] was 4.4 weeks. Delayed recovery [MRT =/>6 weeks] was noted in patients with predominant distal weakness in the LL [MRT 7.8 weeks; p = 0.001], proximal weakness in the upper limb [UL] [MRT 6 weeks; p = 0.005], autonomic disturbance [MRT 6.5 weeks; p = 0.05], and axonal type GBS [MRT 6 weeks; p = 0.001]. The presence of predominant distal weakness in LL, proximal weakness in UL, autonomic disturbance and axonal pattern in NCS predict a poor outcome. Hence we recommend early immunomodulatory therapy in patients presenting with these features