Guillain-Barre Syndrome: A clinical practice survey in India
Journal Title: International Journal of Medical and Health Research - Year 2019, Vol 5, Issue 1
Abstract
Introduction: Guillain-Barre syndrome (GBS), also known as Landry-Guillain-Barre-Strohl syndrome and acute inflammatory demyelinating polyneuropathy (AIDP) is an acute polyradiculoneuropathy disorder having autoimmune pathophysiology. GBS is one of the most common cause of acute or subacute generalized paralysis and diagnosis and treatment is often challenging due to lack of effective therapy measures. Objective: This cross-sectional survey was conducted in physicians across India to understand the prevalence, presenting features and management practices of GBS in Indian population. Methods: A total of 55 physicians who treated GBS in their practice participated in the survey. The customized self-administered survey contains twenty questions which included information on GBS like prevalence, presenting features, diagnosis, treatment preferences, immunoglobulin therapy and its outcomes, relapse and management of relapse. Observations: About 34.5% (19/55) physicians reported higher prevalence of GBS in males, 3.6% (02/55) reported common in females, 3.6% (02/55) reported common in children, whereas 58.2% (32/55) reported no specific variation with respect to gender and children. There was a high seasonal variation reported by 92.7% (51/55) physicians with GBS commonly presented in rainy and winter seasons (94.5%). Diagnosis of GBS was reported to be done using clinical assessment (87.3%), nerve conduction velocity test (90.9%), lumbar puncture with CSF analysis (70.9%), and electromyography (58.2%). Intravenous immunoglobulins (IVIg) was the most preferred therapy with about 90.0% (50/55) physicians. The reasons for preference of IVIg were good clinical response or efficacy (94.2%), ease of administration (90.4%) and safety (92.3%) of IVIg over other treatments. Improvement in GBS symptoms after initiating IVIg therapy was reported to be within 3-15 days by 72.7%(40/55) physicians, whereas 20%(11/55) physicians reported improvement in 15-30 days, and only one (1.8 % 1/55 physician reported improvement after 30 days of starting therapy. Of the 55, only 29 (52.7%) physicians reported adverse events with IVIg therapy and no events were reported by 26 (47.3%) physicians. Conclusion: GBS is common in Indian patients and IVIg is the preferred therapy over other options due to better efficacy, ease of administration and better safety profile.
Authors and Affiliations
Dr. Vinay Chauhan, Dr. Abhijit Das
Keywords
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