Therapeutic Outcomes and Prognostic Factors in Guillain-BarreSyndrome Treated with Intravenous Immunoglobulin

Lee, Jee-Young; Cho, Joong-Yang; Kim, Sung Hun

Ann Clin Neurophysiol > 2004 ;6(2) > Article

Ann Clin Neurophysiol. 2004; 6(2): 92-97.

Jee-Young Lee, Joong-Yang Cho, and Sung Hun Kim

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

ABSTRACT

Background: There were several studies comparing prognostic factors in Guillain-Barre syndrome treated with intravenousimmunoglobulin and plasmapheresis. However, there were controversies in what were significant factors andthere were few studies so far comparing the therapeutic outcomes in patients treated with immunoglobulin. This studywas aimed to determine the prognostic factors which affected the therapeutic outcome of Guillain-Barre syndrome treatedwith intravenous immunoglobulin.Method: We retrospectively reviewed the medical records of patients with Guillain-Barre syndrome admitted to ourhospital between January 1999 and March 2004. All patients were treated with intravenous immunoglobulin. Outcomeand prognosis were followed up after four weeks using the overall disability sum score.
Results: Thirty-six patients were enrolled in this study. According to the clinical and electrophysiological findings,17 patients were AIDP, 10 were axonal forms, two were mixed and seven had electrophysiologically no evidence ofabnormalities. At a follow-up of four weeks, disabilities at the nadir (p<0.001) and admission (P<0.012), initial manifestationsof bulbar symptom (P<0.024) and electrodiagnostic features (P<0.013) were significantly correlated with outcomein patients treated with intravenous immunoglobulin. But only disabilities at the nadir (P<0.033) and electrodiagnosticfeatures (P<0.018) were significant in the multivariate logistic regression analysis.Conclusion: Among the patient treated with intravenous immunoglobulin, the outcomes were significantly differentaccording to the neurological status at the nadir. Therefore early diagnosis, administration of intravenous immunoglobulinand preventing complications during acute stages are essential to minimize neurological deficit and shorten the periodsof recovery.

Key words: Guillain-Barre syndrome, Intravenous immunoglobulin, Prognostic factors