Guillain–Barré Syndrome (GBS) is a leading cause of acute flaccid paralysis worldwide. The disorder is characterized by symmetrical weakness, loss of reflexes, and variable sensory or autonomic features. Reported global incidence ranges between 1 and 2 cases per 100,000 individuals annually. The main electrophysiological patterns include acute inflammatory demyelinating polyneuropathy (AIDP), acute motor axonal neuropathy (AMAN), and acute motor–sensory axonal neuropathy (AMSAN).

Despite the use of intravenous immunoglobulin (IVIg) and plasma exchange (PLEX) as standard treatments, significant variation persists in disease expression and recovery. Mortality, often linked to respiratory insufficiency or autonomic disturbances, remains higher in developing countries. This study aimed to describe the clinical spectrum of GBS, highlight prognostic indicators, and evaluate the outcomes of therapeutic interventions in patients from a tertiary-care center in Tamil Nadu, India.

MATERIALS AND METHODS

Study design: Prospective observational study
Location: Government Chengalpattu Medical College & Hospital, Tamil Nadu
Study period: July 2023 – June 2024
Sample size: 47 patients with confirmed GBS

Eligibility: Patients fulfilling Brighton 2011 diagnostic criteria for GBS were included. Those with acute myelopathies, myasthenia gravis, botulism, porphyria, or toxic neuropathies were excluded.

Data collection: Information was recorded regarding demographic profile, antecedent illness, neurological examination, cerebrospinal fluid characteristics, nerve conduction study findings, and treatment received. Functional status was graded using Hughee’s disability scale at admission, discharge, and three months.

Statistical analysis: Associations were tested using chi-square statistics. A p-value <0.05 was considered statistically significant.

RESULTS

Table 1. Demographic Characteristics (n=47)

Table 2. Clinical Profile

Table 3. Electrophysiological Subtypes

Table 4. Treatment Modalities and Outcomes

Table 5. Predictors of Poor Outcome

DISCUSSION

The present analysis demonstrated that GBS affected individuals predominantly in middle age, with a modest male predominance. AIDP emerged as the most frequent electrophysiological subtype. Respiratory failure, though less common, carried a significant risk for mortality. Compared with Western data, the mortality rate in this cohort was higher, which could reflect delays in seeking medical attention and limited intensive care support. The relatively favorable response to IVIg in our series aligns with the results of prior clinical trials. Autonomic dysfunction, while not universal, was another critical factor influencing outcomes.

CONCLUSION

Guillain–Barré Syndrome remains a potentially life-threatening but treatable neurological disorder. Recognition of prognostic indicators such as advanced age, respiratory involvement, and autonomic instability is crucial. IVIg therapy produced the most consistent recovery outcomes in this study and should be prioritized in management strategies.

REFERENCES

1. Willison HJ, Jacobs BC, van Doorn PA. Guillain–Barré syndrome. Lancet. 2016;388(10045):717–27.
2. Yuki N, Hartung HP. Guillain–Barré syndrome. N Engl J Med. 2012;366:2294–304.
3. Sejvar JJ, Baughman AL, Wise M, Morgan OW. Population incidence of Guillain–Barré syndrome: a systematic review and meta-analysis. Neuroepidemiology. 2011;36(2):123–33.
4. Lawn ND, Fletcher DD, Henderson RD, Wolter TD, Wijdicks EF. Anticipating mechanical ventilation in Guillain–Barré syndrome. Arch Neurol. 2001;58(6):893–8.
5. van den Berg B, Walgaard C, Drenthen J, Fokke C, Jacobs BC, van Doorn PA. Guillain–Barré syndrome: pathogenesis, diagnosis, treatment and prognosis. Nat Rev Neurol. 2014;10:469–82.
6. Hughes RA, Swan AV, van Doorn PA. Intravenous immunoglobulin for Guillain–Barré syndrome. Cochrane Database Syst Rev. 2014;(9):CD002063.