Guillain-Barré syndrome in Bangladesh: validation of Brighton criteria.
Guillain-Barré syndrome has a diverse clinical phenotype related to geographical origin. To date, the majority of large-scale studies on Guillain-Barré syndrome (GBS) have been conducted in developed countries. We aimed to evaluate the key diagnostic features and assess the suitability of the Brighton criteria in 344 adult GBS patients from Bangladesh. All patients fulfilled the National Institute of Neurological Diseases and Stroke (NINDS) diagnostic criteria. Standardized data on demographic characteristics and clinical features, cerebrospinal fluid (CSF) analysis, and nerve conduction study (NCS) results were elaborated to measure the sensitivity of Brighton criteria. Most patients (88%) were admitted to hospital after the nadir weakness. Symmetrical weakness and reduced reflexes were found in 98% of patients. CSF albuminocytologic dissociation was detected in 238/269 (89%) cases and abnormal nerve physiology in 258/259 (>99%) cases. Only 27 (8%) patients received either intravenous immunoglobulin (IVIg) or plasmapheresis. In total, 200 (58%) patients met level 1 of the Brighton criteria; 97 (28%) patients met level 2; 42 (12%) patients met level 3; and 5 (2%) patients met level 4. This analysis showed that despite the heterogeneity of GBS in Bangladesh, the Brighton criteria showed a high sensitivity in the diagnosis of GBS.
Emerging Diseases and Immunobiology Research Group, Laboratory Sciences and Services Division, International Centre for Diarrhoeal Disease Research, (icddr,b), Dhaka, Bangladesh.|Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Centre, Rotterdam, The Netherlands.
Mohammad B
MB
Islam
Emerging Diseases and Immunobiology Research Group, Laboratory Sciences and Services Division, International Centre for Diarrhoeal Disease Research, (icddr,b), Dhaka, Bangladesh.
Zhahirul
Z
Islam
Emerging Diseases and Immunobiology Research Group, Laboratory Sciences and Services Division, International Centre for Diarrhoeal Disease Research, (icddr,b), Dhaka, Bangladesh.
Kaniz S
KS
Farzana
Emerging Diseases and Immunobiology Research Group, Laboratory Sciences and Services Division, International Centre for Diarrhoeal Disease Research, (icddr,b), Dhaka, Bangladesh.
Sumit K
SK
Sarker
Emerging Diseases and Immunobiology Research Group, Laboratory Sciences and Services Division, International Centre for Diarrhoeal Disease Research, (icddr,b), Dhaka, Bangladesh.|Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Centre, Rotterdam, The Netherlands.|Fondation Mérieux, Lyon, France.
Hubert P
HP
Endtz
National Institute of Neurosciences and Hospital, Dhaka, Bangladesh.
Quazi D
QD
Mohammad
Departments of Neurology and Immunology, Erasmus University Medical Centre, Rotterdam, The Netherlands.
Bart C
BC
Jacobs
D000328:Adult; D001459:Bangladesh / Q000453:epidemiology; D004594:Electrophysiology; D005260:Female; D020275:Guillain-Barre Syndrome / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000379:methods* / Q000592:standards; D010956:Plasmapheresis; D012026:Reflex, Stretch / Q000187:drug effects / Q000502:physiology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric
D016756:Immunoglobulins, Intravenous
Bangladesh; Brighton criteria; Guillain-Barré syndrome; National Institute of Neurological Diseases and Stroke criteria; cerebrospinal fluid; nerve conduction study