ICNC Abstracts, ICNC 2018

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EARLY CLINIC-ELCTROPHYSIOLOGICAL PREDICTORS OF POOR FUNCTIONAL OUTCOMEIN GBS
EKTA AGARWAL

Last modified: 2018-09-09

Abstract


Introduction- Guillian- Barre syndrome (GBS), an acute inflammatory polyradiculoneuropathy, has varied clinical severity and diverse outcome.

AIM- To study clinical and electrophysiological profile of children with GBS and to determine early predictors of poor functional outcome

Material and methods- We retrospectively analyzed data of 25 children with GBS managed in the last 4 years. Various clinical and electrophysiological parameters were evaluated and factors associated with poor functional outcome and prolonged hospital stay, were determined. Hughes disability scale was used to measure functional outcome.

Results-64% of enrolled children were boys. 72% had Acute Motor Axonal Neuropathy (AMAN) and 28% Acute Inflammatory Demyelinating Polyneuropathy (AIDP). 6 children developed bulbar palsy and 5 required ventilatory support. Average duration of hospital stay in non-ventilated patients and average time to independent walking were more prolonged in patients with AMAN than in AIDP variant. Electro-physiologically, the ulnar nerve was more severely involved than median nerve and the peroneal nerve more than tibial nerve. The early predictors of poor functional outcome, as defined by inability to walk independently at 4 weeks and duration of hospital stay more than 15 days, included:

-Requirement for ventilator support (p=0.015)

-Axonal variant

-Presence of inexcitable nerves (p=0.050)

- NCV finding of Right- left asymmetry of involvement of peripheral nerves (p=0.002)

Conclusion- Inexcitable nerves, asymmetrical involvement of peripheral nerves and AMAN variant were associated with poor outcome. Ulnar and peroneal nerves were more severely involved in most patients. Small sample size was a limitation of the study.


Keywords


GBS, functional outcome

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