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The recurrent Guillain–Barré syndrome: a long‐term population‐based study
Author(s) -
Mossberg N.,
Nordin M.,
Movitz C.,
Nilsson S.,
Hellstrand K.,
Bergström T.,
Andersson B.,
Andersen O.
Publication year - 2012
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.2012.01667.x
Subject(s) - medicine , guillain barre syndrome , etiology , pediatrics , serology , population , chronic inflammatory demyelinating polyneuropathy , neurology , univariate analysis , multivariate analysis , immunology , antibody , environmental health , psychiatry
Objectives To describe a population‐based material of patients with recurrent Guillain–Barré syndrome ( RGBS ), examine the long time course, and search for factors predisposing to recurrence. Materials and methods We performed a follow‐up study of the neurology and neurophysiology and a systematic study of the acute microbial serology of patients with RGBS . These parameters were compared with the results of a previous study of monophasic GBS . Results The patients with RGBS ( n = 15) were retrieved from admissions of 229 patients with GBS during a 17‐year period. They had 2–7 (median 3) episodes occurring at irregular intervals over decades. Of the 11 patients who accepted a follow‐up examination, six were in full remission, and five had moderate sequelae. Nine had a demyelinating subtype, one had an axonal motor variant, and one patient with incomplete Miller Fisher syndrome had associated arachnoiditis. Two patients showed ultimate transition to a course similar to chronic inflammatory demyelinating polyneuropathy. Episodes were generally shorter in RGBS than in GBS , and an initial episode duration <45 days was predictive of recurrence and related to a younger onset age (univariate P = 0.005–0.009). Triggering infections occurred in all patients, in 32 of 41 episodes (78%) with few examples of etiological promiscuity. Serological findings did not differ from those in GBS . Conclusions Episodes in RGBS were shorter than in monophasic GBS . We were unable to identify further immunological predisposing factors for recurrence beyond the previously demonstrated relationship to a weaker respiratory burst. We observed no obvious tendency for the recurrence frequency to wane.