The Subtypes And Prognosis Of Guillain-barre Syndrome

Objective: To analyze the clinical subtypes and prognosis amongpatients with Guillain-Barré syndrome(GBS),and to explore the clinicalfeatures, prognosis of the different variants of GBS,and prognosticpredictors of GBS.Methods: Patients with GBS admitted to the First Affiliated HospitalOf Chong Qing Medical University, from2006-2013were collected, anddivided into acute inflammatory demyelinating polyneuropathy (AIDP)group,acute motor axonal neuropathy (AMAN) group,Miller-Fishersyndrome (MFS) group， cranial nerve variants(CNV)， Bickerstaff’sbrainstem encephalitis overlaps with Guillain-Barre syndrome (BBE-GBS)gruop and unclassifiable group based on clinical features andelectrophysiological findings， and divided patients into two groups basedon Hughes functional grading scale for different prognosis of GBS.Patientswere followed-up for6months.The clinical characteristics, prognosis ofdifferent subtypes and predictors of prognosis were analyzed.Results: AIDP group97cases (57%), AMAN group of37cases (22%),MFS group of12cases (7%), CNV group8(5%), BBE-GBS group of8cases (5%), the other group of8cases(5%). HFGS(score) was used to assesthe prognosis at3and6months.The prognosis of AMAN and BBE-GBS group at3months （F=3.29，P=0.0704） and6months（F=1.97，P=0.1614） had no statistical significance. The Prognosis ofAMAN is worse than AIDP at3months(F=10.33，P=0.0014)and6months(F=15.26，P=0.0001) follow-up, the difference was statisticallysignificant. Outcome of MFS group and cranial nerve group at6monthswere both good.Logistic regression analysis revealed that the Hughesscores of3or more points atpeak[P<0.0001， OR=6.650、95%CI(2.865,15.023)], autonomic nervedysfunction[P=0.0435， OR=2.820、95%CI(1.031,7.715)] are associatedwith poor outcome at6months.Conclusion: AIDP is the main subtype of GBS.Prognosis of AMANgruop and BBE-GBS group are both poor than AIDP’s at3months and6months follow-up; Prognosis of Cranial nerve variant and MFS group areboth good. The critical patients and autonomic nerve dysfunction arepredictors os the poor prognosis at6months.