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 144
- Downloads 0
Impact of Nano Hydroxyapatite, Nano Silver Fluoride and Sodium Fluoride Varnish on Primary Teeth Enamel Remineralization: An In Vitro Study
Introduction: Dental caries is still prevailing worldwide, although different anti caries products have been introduced. Each remineralizing agent has its own shortcomings. Therefore, looking for new agents to have benef...
Delayed Post-Surgical Hypoparathyroidism: The Forgotten Chameleon!
Delayed hypoparathyroidism, due to accidental gland removal or ischemia of parathyroids can present many years after thyroidectomy and symptoms may be non-specific. This condition, if not diagnosed timely, may prove fata...
The Association between Birth Order and Academic Performance of Undergraduate Dental College Students in Riyadh, Saudi Arabia
ABSTRACT Introduction: Children in the same family are different from each other in their academic achievement and birth order plays an important role in defining a child’s character and personality. Grade Point Average...
Role of X-linked Inhibitor of Apoptosis Protein as Cancer Biomarker
X-linked Inhibitor of Apoptosis Protein (XIAP), is one of the most important apoptotic inhibitors that plays a vital role in regulating various aspects of cell functions including cell cycle progression, arrest, and apop...
Bilateral Single System Orthotopic Ureterocele with Bilateral Multiple Calculi Presented with Retention of Urine - an Urological Emergency
The ureterocele is an uncommon congenital anomaly of the lower ureter. Ureterocele with a single pelvicalyceal system, bilateral, and orthotopic variety is less common. Calculi within bilateral ureterocele are a rare occ...