Autonomic Dysfunction in Patients with Guillain-Barré Syndrome in Sub-Acute Phase
Journal Title: Journal of Clinical and Diagnostic Research - Year 2019, Vol 13, Issue 6
Abstract
ABSTRACT Introduction: Autonomic involvement is seen in two-thirds of Guillain-Barré Syndrome (GBS) patients. Aim: To evaluate the pattern and extent of autonomic dysfunction in GBS patients in sub-acute phase and its association with severity in GBS patients. Materials and Methods: A cross-sectional study was conducted in 29 GBS patients in Department of Neurological Rehabilitation at a tertiary care institute. All consecutive patients diagnosed with GBS fulfilling the inclusion criteria were subjected to laboratory cardiac autonomic tests. To assess the fatigue Fatigue Severity Scale (FSS) was used, disability status was assessed by Hughes Disability Scale (HDS), and muscle weakness was assessed by Medical Research Council (MRC) sum scores. Statistical analysis was done by Stata 11. The significance of p-value was considered at 0.05. Results: Twenty-nine patients were included with 17 (59%) men and mean age of 31 years. On Heart Rate Variability (HRV) test 26 (90%) patients had reduced power, 15 (52%) patients had sympathovagal balance and 14 (48%) had sympathovagal imbalance with sympathetic dominance. On conventional cardiac testing 16 (55%) patients had cardiac involvement. On tilt table 5 (17%) patients had Postural Orthostatic Tachycardia Syndrome (POTS) and 3 (10%) patients had orthostatic hypotension. Significant association was found on HRV and conventional cardiac autonomic tests with duration between disease onset and testing (p=0.04) and (p=0.01) respectively. Significant association of reduced power was found with presence of antecedent events (p=0.01) and duration between disease onset and testing (p=0.01). Sympatho vagal imbalance showed significant association with presence of respiratory distress and need for ventilator (p=0.04). Conclusion: Laboratory cardiac autonomic tests are non-invasive and easily applicable to quantitatively evaluate autonomic dysfunction even in severely disabled GBS patients. Autonomic dysfunction is common in patients with pulmonary involvement. However, it has no relation with the severity of motor disability. This study suggests that autonomic dysfunction in GBS should be studied even during the sub-acute phase.
Authors and Affiliations
Nidhi Rawat, Meeka Khanna, MR Rukmani, Partha Haldar
Keywords
Related Articles
- EP ID EP605383
- DOI 10.7860/JCDR/2019/41693.12947
- Views 138
- Downloads 0
Versatility of Tongue Flaps for Closure of Palatal Defects- Case Report
Palatal defects following congenital anomalies, traumatic injuries, benign and malignant pathologies frequently require resection and reconstruction. Reconstruction of these defects is challenging and complex due to the...
Proliferative Fasciitis in Childhood: A Review of Clinical Data Apropos of a Case
Proliferative Fasciitis (PF) is a benign lesion with histologic and clinical features overlapping with those of malignant soft tissue tumours. Its occurrence in children is considered very rare. We present a case of PF a...
Usefulness of B-Type Natriuretic Peptide in Predicting the Involvement of Right Ventricle in Acute Inferior Wall Myocardial Infarction
Introduction: Cardiovascular Disease (CVD) is the leading cause of deaths globally as the death rate due to CVD has increased from 26% in 1990 to 29.5% in 2010. The Acute Coronary Syndrome (ACS) includes acute Myocardial...
Pleiotropic Effects of Losartan in Hypertensive Patients with Dyslipidemia
Introduction: In essential hypertension, the comorbidity of dyslipidemia is very common. In addition to hypertension, dyslipidemia is linked to cardiovascular disease, stroke and decline in renal function. Unlike other a...
Hair, Nails and Oral Mucosal Disorders among People Living with Human Immunodeficiency Virus and AIDS in Osogbo and Diagnostic Performance on Low CD4 Cells Count
Introduction: The epidemic of HIV/AIDS continues amidst reduce funding in most low and middle-income countries. The need to find low-cost clinical equivalents of the laboratory markers of immunosuppression, therefore bec...