Dados do Trabalho

Título

Epidemiological and Clinical Characteristics of Guillain-Barré Syndrome Cases treated at a public university hospital in Brazil between 2014-2020.

Resumo

Introduction: Guillain-Barré syndrome (GBS) is the most common acute inflammatory neuropathy, which causes sensitive and motor symptoms, and can also be associated with dysautonomia. In Brazil, there are few epidemiological and systematized regional studies about the syndrome. Objective: The aim of the present study is to evaluate the epidemiological, clinical, and neurophysiological aspects of patients with GBS, treated at a public university hospital, between 2014 and 2020. Methods: It is a retrospective study made by the analysis of 64 medical charts of patients diagnosed with GBS, between January 2014 and December 2020. Results: The majority of the patients are men (70,3%), with an average age of 39,1/±23,3. 79,7% of the patients claim to have had an infection before the symptoms, especially gastrointestinal (51.0%), respiratory (25.5%), and arboviruses (13.7%). Only 3.1% had a recent vaccination. Among the clinical forms of GBS, the most common was the classic sensory-motor form (70.3%) followed by the pure motor form (23.4%). The pharyngeal-cervical-brachial (3.1%), paraparetic (1.6%), and Miller-Fisher (1.6%) forms were less commonly observed. Regarding the physical examination at admission, all cases presented muscle weakness. Areflexia or hyporeflexia was present in 89.1% of the patients. Other clinical findings observed: sensory ataxia (48.4%), pain (46.9%), hypopalesthesia (43.8%), hypoesthesia (40.6%), paresthesia/dysesthesia (39.1%). 34.4% of the patients had involvement of some cranial nerve and 23.4% had facial paresis. Dysautonomic symptoms such as tachycardia, dyspnea, and urinary retention/intestinal constipation have been observed in 23.4%, 17.2%, and 9.4%, respectively. In 25.0% of the cases, there was an asymmetric distribution of sensory abnormalities and in the assessment of motor function, there was a proximal predominance in 84.4% and an asymmetric distribution in 40.6%. The AMAN and PIDA neurophysiological patterns were the most commonly observed, both present in 40.3% of patients who underwent electroneuromyography. The time between symptoms onset and admission was 14.2/±13.0 days, with a hospital stay of 11.3/±11.4. 15.6% required ICU admission and 12.5% developed respiratory failure and required mechanical ventilation. Conclusion: In the context of public health, it is important to recognize the clinical and epidemiological aspects of the GBS cases, to elaborate more efficient diagnosis and treatment strategies.

Palavras Chave

Guillain-Barré syndrome; Epidemiology; Inflammatory neuropathy.