Abstract
Background
Guillain–Barre syndrome (GBS) presents an annual incidence of 1.2–2.3 per 100,000.
Sympathetic and parasympathetic nervous systems' peripheral control of visceral organs
is affected by GBS aberrant immune response. Associated cardiovascular, gastrointestinal,
sudomotor, pupillary, and other systems disturbances cause significant morbidity and
mortality. This study aims to evaluate the dysautonomia spectrum in GBS patients,
its relationship with patient outcomes, and compare it with those without autonomic
disturbances.
Methods
We performed an ambispective review study of patients with GBS and dysautonomia admitted
to the Institute of Neurology from 2017 to 2021. We recorded demographics, comorbidities,
nerve conduction studies, clinical course, hospital complications, and functional
outcomes.
Results
We included 214 patients, mean age 46.44 ± 16.49 years, 51 (31 %) presented dysautonomia,
hypertension in most of the patients 39 (84.8 %), hypotension 35 (76.1 %), tachycardia
35 (76.1 %), enteric dysmotility 35 (76.1 %), and need for vasopressor 27 (58.7 %)
were common characteristics. Twenty (39.2 %) with a demyelinating form and twenty
(39.2 %) with an axonal motor form. The bivariate analysis report factors associated
with dysautonomia, were lower cranial nerves (VII, IX, X) involvement (p = 0.002), need for mechanical ventilation (p = 0.0001) and intensive care (p = 0.0001), higher mEGOS (p = 0.05), EGRIS (p = 0.004), GBS disability score (p = 0.004), and delirium presence (p = 0.001). Kaplan-Meier survival analysis showed that dysautonomic patients needed
more days for the independent walk (p = 0.004). There was no associated mortality.
Conclusions
Autonomic dysfunction in GBS significantly affects the peripheral nervous system.
With consequently worse functional results. Further investigation needs to clarify
whether more aggressive treatment is beneficial in this category of GBS.
Keywords
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Article info
Publication history
Published online: December 20, 2022
Accepted:
December 19,
2022
Received in revised form:
November 14,
2022
Received:
May 29,
2022
Identification
Copyright
© 2022 Published by Elsevier B.V.
