The Clinical Characteristics Of Acute Demyelinating And Axonal Guillain-Barré Syndrome

Object:Retrospective analysis and summary of the clinical features of different types of Guillain-Barré syndrome.Methods: We collected the clinical data of the hospitalized patients with GBS from June 2015 to June 2018 in Tongji hospital.According to the clinical characteristics and the results of the EMG,they were diagnosed as AIDP、AMAN、AMSAN and MFS.Then classified the AIDP cases as the demyelinating group,classified the AMAN and AMSAN cases into axonal group,compare and analyse the clinical data in each group.Results: A total of 92 cases of GBS were collected,including 37 AIDP,37 AMAN,11AMSAN and 7MFS,then classifying them into demyelinating group(37cases)and axonal group(48cases).There were no statistical differences as to onset age between the two groups.The average age of the patients in the axonal group was 53±13.9 years old.Men made up the majority in both groups,and there was no statistical difference in the gender composition between the two groups.Precedent events before onset were common.The demyelinating group often had a history of upper respiratory tract infection,while the axonal group had the most commonly history of trauma.In addition,the axon group had a significantly higher history of trauma than the demyelinating group,and the difference was statistically significant.The average time before admission was generally 10-12 days,and the condition of axonal group was significantly worse than that of demyelinating group at admission.The peak duration of the disease was similar between the two groups,with an average of about 8±5 days.The severity at nadir was significantly worse in axonal group than that of demyelinating group.Dyskinesia was the most common onset symptom,followed by paresthesia.The onset symptom of paresthesia was significantly more n demyelinating group than that of axonal group,and the difference was statistically significant.There were no statistical differences in both group as to motor dysfunction,respiratory muscle involvement,mechanical ventilation,autonomic nerve dysfunction and areflexia.The incidence of paresthesia and cranial nerve involvement was significantly higher in the demyelinating group than axonal group.There were no significant differences between the two groups in terms of CSF protein cell isolation,positive rate of serum autoimmune antibody and ganglioside antibodies,in the use of prednisolone,IVIg and plasma exchange therapy.The short-term prognosis of axonal group was significantly worse than that of demyelinating group,while there was no significant difference in long-term prognosis between the two groups.Conclusions: The clinical characteristics of demyelinating GBS and axonal GBS are different,the severity of the disease at the peak is different,and the prognosis is not the same,so the early diagnosis and early treatment of different type GBS is of great significance.