Temporal profile of pain and other sensory manifestations in Guillain-Barre' syndrome during ten days of hospitalization.
BACKGROUND
Focused studies on sensory manifestations, especially pain and paresthesia in Guillain-Barre' (GB) syndrome are few and far between.


OBJECTIVE
To study the sensory manifestations in GB syndrome during 10 days of hospitalization with clinico-electrophysiological correlation.


METHODS
The study included 60 non-consecutive patients with GB syndrome, fulfilling National Institute of Neurological and Communicative Disorders and Stroke (NINCDS) criteria for GB syndrome. Data especially related to clinical and electrophysiological evidence of sensory involvement were analyzed. Pain was assessed using a) visual analogue paraesthesias (Vapar), b) visual analogue for pain (Vap) and c) verbal rating scale for pain (Verp).


RESULTS
Sensory symptoms were widely prevalent: paraesthesia in 45 (75%) patients and pain in 30 (50%) patients. Impairment of different sensory modalities included: pain in 8 (13.3%), joint position sense in 14 (23.3%), and vibration in 11 (18.3%). Electrophysiological evidence of abnormal sensory nerve conduction was noted in 35 (58.3%) patients. Pain assessment using Vapar, Vap and Verp for from Day 1 to Day 10 of hospitalization revealed that from Day 7 onwards the degree and frequency of sensory symptoms and signs decreased. On comparing various clinico-electrophysiological parameters among patients of GB syndrome with and without pain and paresthesia. Presence of respiratory distress correlated with pain and paresthesia (P=0.02).


CONCLUSIONS
Sensory manifestations in GB syndrome are often under-recognized and under-emphasized. This study analyzed the evolution and the profile of pain and paresthesia in GB syndrome during hospitalization. Knowledge, especially about evolution of pain and paresthesia during hospitalization might improve understanding and patient care.
Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India.
K
K
Karkare
Arun B
AB
Taly
Sanjib
S
Sinha
S
S
Rao
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D005260:Female; D020275:Guillain-Barre Syndrome / Q000150:complications*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000209:etiology*; D010147:Pain Measurement; D010292:Paresthesia / Q000175:diagnosis / Q000209:etiology*; D012678:Sensation Disorders / Q000175:diagnosis / Q000209:etiology*; D012720:Severity of Illness Index; D013997:Time Factors; D055815:Young Adult