GUILLAIN-BARRÉ SYNDROME: DIAGNOSIS, TREATMENT, AND EMERGING INSIGHTS “NAVIGATING THE COMPLEXITIES OF GUILLAIN-BARRÉ SYNDROME: CASE STUDIES AND PERSPECTIVES”
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Keywords
Guillain-Barré Syndrome, intravenous immunoglobulin, neuromuscular disorders , autonomic dysfunction, prevalence.
Abstract
Background: Guillain-Barré Syndrome (GBS) is an acute immune-mediated polyneuropathy requiring critical care management. The primary treatment modality include intravenous immunoglobulin (IVIG) aimed at halting disease progression. This study evaluates the clinical profile, treatment response, and outcomes in GBS patients admitted to the ICU, with a focus on treatment modalities .
Methods: A prospective observational study was conducted at the Department of Medicine, Government Medical College Srinagar, including 100 patients diagnosed with GBS. Data on demographic profile, clinical presentation, treatment received , ventilatory support, complications, and outcomes were analyzed.
Results: A total of 100 patients diagnosed with Guillain-Barré Syndrome (GBS) were included in the study. The mean age of the patients was 44.3 ± 13.2 years, with a male-to-female ratio of 1.7:1. The most common presenting symptom was progressive limb weakness (85%), followed by paresthesia (62%) and cranial nerve involvement (40%). Among the patients, 100% received IVIG as the primary treatment. The mean hospital stay was 16.8 ± 6.4 days, with ICU admission required in 38% of cases. Ventilatory support was required in 30% of patients, with invasive mechanical ventilation needed in 18%. The most common complications observed were autonomic dysfunction (30%), pneumonia (22%), and deep vein thrombosis (8%). At the three-month follow-up, 67% of patients showed significant improvement, while 8% had persistent disability. The mortality rate was 5%, primarily due to sepsis and respiratory failure.
The most common clinical presentation was lower limb weakness progressing to upper limbs in an ascending manner. Cranial nerve involvement was observed in 40% of patients, with facial nerve palsy (20%) being the most frequent.
Conclusion: GBS remains a critical neurological emergency requiring prompt immunomodulatory therapy. IVIG was the most commonly used treatment. The need for mechanical ventilation was associated with a higher risk of complications and mortality. Timely initiation of treatment, supportive care, and early rehabilitation significantly impact outcomes.
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Dr. Ajay Kumar Dogra
Senior Resident, Department of General Medicine Government Medical College, Jammu, India.
Dr. Bhumesh Kumar Angural
Postgraduate Scholar, Department of General Medicine, Government Medical College Srinagar, India.
Dr. Mohd Israr
Postgraduate Scholar, Department of General Medicine, Government Medical College Srinagar, India.
Dr. Shahanawaz Ahmad
Postgraduate Scholar, Department of General Medicine, Government Medical College Srinagar, India.
Dr. Sayima Nargis
Postgraduate Scholar, Department of Obstetrics and Gynaecology, Dr. Ram Monohar Lohia Hospital Hospital, New Delhi, India.