Clinical and neurophysiological pattern of Guillain-Barré syndrome in Kuwait.
OBJECTIVE
To study the clinical and neurophysiological pattern of Guillain-Barré syndrome (GBS) in Kuwait.


METHODS
The clinical records of consecutive GBS patients admitted to Ibn Sina Hospital, Kuwait, during a 7-year period between 1997 and 2003 were analyzed.


RESULTS
Of the 41 cases, 77% were male. The majority of the cases presented during the winter months and a preceding infection was reported in two thirds of them. Proximal lower limb (LL) weakness was the predominant clinical presentation. Nerve conduction studies (NCS) demonstrated a demyelinating pattern in 70%, an axonal pattern in 15%, mixed type in 5% and no abnormality in the remaining 5%. The majority of the patients (73%) improved with one course of intravenous immunoglobulin (IV IG). Mean recovery time (MRT) was 4.4 weeks. Delayed recovery (MRT > or =6 weeks) was noted in patients with predominant distal weakness in the LL (MRT 7.8 weeks; p = 0.001), proximal weakness in the upper limb (UL) (MRT 6 weeks; p = 0.005), autonomic disturbance (MRT 6.5 weeks; p = 0.05), and axonal type GBS (MRT 6 weeks; p = 0.001).


CONCLUSIONS
The presence of predominant distal weakness in LL, proximal weakness in UL, autonomic disturbance and axonal pattern in NCS predict a poor outcome. Hence we recommend early immunomodulatory therapy in patients presenting with these features.
Department of Neurology, Ibn Sina Hospital, Kuwait. Nagarajanusharani@hotmail.com
Venkatesan
V
Nagarajan
Asmahan
A
Al-Shubaili
D000293:Adolescent; D000328:Adult; D000368:Aged; D004594:Electrophysiology; D005260:Female; D020275:Guillain-Barre Syndrome / Q000453:epidemiology* / Q000503:physiopathology*; D006801:Humans; D007730:Kuwait / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D020127:Recovery of Function