title: A study of Guillain-Barré syndrome with reference to cranial neuropathy and its prognostic implication.
abstract: BACKGROUND
  Focused studies on cranial neuropathy in Guillain-Barré syndrome (GBS) and its prognostic implication are not done previously.
  
  
  OBJECTIVE
  To study the clinical profile of GBS patients with special reference to cranial neuropathy and its prognostic implication.
  
  
  METHODS
  The study included 61 patients with GB syndrome, fulfilling Asbury Cornblath's criteria for GB syndrome. A pre-designed semi-structured questionnaire was used to obtain data regarding demographic profile and clinical profile. All patients underwent detailed neurological examination, investigations including nerve conduction studies and CSF examination and treated according to the severity of the illness. Patients were followed up for 6 months. During analysis two groups were made depending on cranial nerve involvement, and compared with respect to various parameters.
  
  
  RESULTS
  Out of 61 patients 38 (62.3%) patients had cranial nerve palsies, in that 25 had multiple cranial nerve palsies, and 13 had single isolated nerve palsy. A majority of 30 (49.2%) had bulbar palsy, 28 (46%) had facial nerve palsy, and all had bilateral involvement except 3 patients who had unilateral palsy. Hypoglossal nerve involvement was seen in six (10%) patients and four (6.5%) patients had ophthalmoplegia. Only one had bilateral vestibulocochlear nerve palsy. On comparing various clinico-electrophysiological parameters among patients of GB syndrome with and without cranial nerve involvement, the presence of respiratory paralysis, IVIg and ventilatory support requirement had significant association with cranial nerve involvement in GBS.
  
  
  CONCLUSIONS
  Our study found a correlation between cranial nerve palsies and severity of the illness. Cranial nerve innervated muscles recover earlier as compared to distal limb muscles. No association was found between outcome at 6 months and cranial nerve involvement.
authors.affiliation: Department of Neurology, Dr. Sampurnanand Medical College, Jodhpur, Rajasthan, India.
authors.forename: Amita
authors.initials: A
authors.lastname: Bhargava
authors.affiliation: Department of Neurology, Dr. Sampurnanand Medical College, Jodhpur, Rajasthan, India.
authors.forename: Basavaraj F
authors.initials: BF
authors.lastname: Banakar
authors.affiliation: Department of Neurology, Dr. Sampurnanand Medical College, Jodhpur, Rajasthan, India.
authors.forename: Guruprasad S
authors.initials: GS
authors.lastname: Pujar
authors.affiliation: Department of Neurology, Dr. Sampurnanand Medical College, Jodhpur, Rajasthan, India.
authors.forename: Shubhakaran
authors.initials: S
authors.lastname: Khichar
keywords: Bulbar palsy; Guillain–Barré syndrome; facial palsy