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Three-Year Follow-Up Study in Patients with Guillain-Barré Syndrome

  • Vesna Martic (a1), Ivo Bozovic (a2), Ivana Berisavac (a2), Ivana Basta (a2), Stojan Peric (a2), Milica Babic (a3), Sonja Lukic Rajic (a4), Bogdan Bjelica (a2), Olivera Stojiljkovic Tamas (a1), Aleksandar Stojanov (a5), Marija Grunauer (a1), Mina Cobeljic (a2), Nenad Komatina (a1), Vanja Djuric (a5), Milutin Petrovic (a6), Balsa Vujovic (a7), Aleksandra Dominovic Kovacevic (a3), Gordana Djordjevic (a5), Dejana Jovanovic (a2) and Zorica Stevic (a2)...

Abstract

A majority of patients with Guillain-Barré syndrome (GBS) have tendency of a good recovery. Our aim was to evaluate the outcome of the disease 1 and 3 years after GBS symptom onset. Methods: During 2014, GBS was diagnosed in 82 patients in seven tertiary healthcare centers. Neurological follow-up was conducted in 57 (70%) patients after 1 year, and in 54 (66%) after 3 years. Functional disability was estimated according to the GBS disability scale (GDS), with a score of 0-3 indicating mild disability and a score of 4-6 indicating severe disability during acute phase, whereas a score >1 indicated poor recovery on follow-ups. Visual analog scale was used to assess sensory symptoms and musculoskelatal pain, and Krupp’s Fatigue Severity Scale was used to asses fatigue. Results: Poor functional outcome was found in 39% of GBS patients at year 1 and 30% at year 3. Paresthesias/dysesthesias were detected in 60% of patients after 1 year and 43% after 3 years. Musculoskeletal pain was present in 40% of patients at year 1 and 33% at year 3. Significant fatigue after 1 year was found in 21% of subjects and after 3 years in 7%. Parameters associated with poor functional outcome after 1 year were age >55 years (p=0.05), severe disability at admission (p<0.05), and on discharge (p<0.01). Poor functional outcome after 3 years was associated with male gender (p<0.05) and severe disability on discharge (p=0.06). Conclusion: One and even three years after GBS onset, a substantial number of patients had neurological sequelae, including functional disability, sensory symptoms, pain, and fatigue.

Étude de suivi d’une durée de trois ans chez des patients atteints du syndrome de Guillain-Barré. Contexte: La majorité des patients atteints du syndrome de Guillain-Barré (SGB) ont tendance à jouir d’une bonne récupération. Le but de notre étude a donc été d’évaluer l’évolution de cette maladie un an et trois ans après l’apparition de ses premiers symptômes. Méthodes: En 2014, le SGB a été diagnostiqué chez 82 patients ayant fréquenté sept centres de soins de santé de troisième ligne. Un suivi neurologique a été mené au bout d’un an auprès de 57 patients (70%); et, au bout de trois ans, auprès de 54 d’entre eux (66%). Leur incapacité fonctionnelle a été évaluée en fonction de l’échelle d’incapacité du SGB. Rappelons qu’un score entre 0 et 3 indique une incapacité légère; qu’un score entre 4 et 6, une incapacité sévère durant la phase aiguë du syndrome; et finalement qu’un score >1 indique une récupération difficile au moment des suivis. L’échelle visuelle analogue (EVA) a aussi été utilisée pour évaluer leurs symptômes sensoriels et leurs douleurs musculo-squelettiques. Enfin, l’échelle de gravité de la fatigue de Krupp a été utilisée pour évaluer leur degré de fatigue. Résultats: La première année, on a observé une piètre amélioration des capacités fonctionnelles chez 39% des patients atteints du SGB; pour la troisième année, cette proportion était de 30%. Au bout d’un an, on a aussi détecté la présence de paresthésie/dysesthésie chez 60% des patients; pour la troisième année, cette proportion était de 43%. Des douleurs musculo-squelettiques ont été rapportées chez 40% des patients après un an; deux ans plus tard, ce pourcentage chutait à 33%. Enfin, un état de fatigue important a été noté chez 21% des patients au bout d’un an; ce pourcentage n’était plus que de 7% au bout de trois ans. Les paramètres associés à une piètre amélioration des capacités fonctionnelles au bout d’un an étaient l’âge (>55 ans; p=0,05) ainsi qu’une incapacité sévère au moment de leur admission (p<0,05) et de leur congé (p<0,01). Au bout de trois ans, une piètre amélioration des capacités fonctionnelles était associée au sexe masculin (p<0,05) et à une incapacité sévère au moment d’obtenir un congé (p=0,06). Conclusions: Un an et trois ans après l’apparition des premiers symptômes du SGB, un nombre important de patients donnaient à voir des séquelles neurologiques, ce qui incluait une forme ou une autre d’incapacité fonctionnelle, des symptômes sensoriels, des douleurs et un état de fatigue.

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Copyright

Corresponding author

Correspondence to: Stojan Peric, Neurology Clinic, Clinical Center of Serbia 6, Dr Subotica Street, 11 000 Belgrade, Serbia. Email: stojanperic@gmail.com

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