THE CLINICAL PRESENTATION, EPIDEMIOLOGY, AND SHORT-TERM OUTCOME OF GUILLAIN-BARRÉ SYNDROME IN TIKURANBESSA HOSPITAL: A 6-YEAR RETROSPECTIVE STUDY

Tigist Bacha, Wondemagegne Gezahegn, Ashenafi Tazebew

Abstract


Introduction: Gullian-Barré Syndrome (GBS) is an acute monophasic demyelinating polyradiculoneuropathy which is characterized by progressive weakness and areflexia. Different antecedent events are associated with GBS and one of those is an anti-rabies vaccine prepared from infected animal brain.

Objective: The study goal was to determine epidemiological features of and to describe the clinical and short-term outcomes of Gullian-Barré syndrome.

Materials and Methods: A cross sectional descriptive study with retrospective data collection was done on children admitted with a diagnosis of Gullian-Barré Syndrome from September 2006 to September 2012.

Result: 112 children were identified. The male to female ratio was 1.6. All had motor weakness, only one patient (0.9%) had sensory loss, 34(30.3%) had cranial nerve involvement and 37 (32.9%) had dysautonomia. Respiratory involvement which necessitated ventilation was found in 14 (12.5%) of our cases. Antecedent events were recorded in 82 (73.2%) of children and among them; upper respiratory infection (URTI) was the most frequent (43.8%). Of the 15 patients with vaccination antecedents, 7 (6.35%) had received anti-Fermi type rabies vaccine. The GBS subtype distribution among the 31 patients who had electrodiagnostic studies performed was as follows: acute inflammatory demyelinating neuropathy (AIDP) 3 (10%), acute motor axonal neuropathy (AMAN) 24 (80%),acute motor-sensory axonal neuropathy (AMSAN) 1 (3.3%), and both axonal and demyelinating neuropathy 3 (10%). Complete recovery was noted in 31 (27.7%) patients and there were 9 (8%) deaths.

Conclusion: Male preponderance and presence of antecedent illness was observed in the majority of subjects. Acute motor axonal neuropathy was the commonest subtype of Guillain-Barré. Prior anti-Fermi-type rabies vaccine may have been one predisposing factor.

Keywords: Guillain-Barré syndrome, Rabies vaccine, Ethiopia

 


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