Risk factors for treatment related clinical fluctuations in Guillain-Barré syndrome. Dutch Guillain-Barré study group
The risk factors for treatment related clinical fluctuations, relapses occurring after initial therapeutic induced stabilisation or improvement, were evaluated in a group of 172 patients with Guillain-Barre syndrome. Clinical, laboratory, and electrodiagnostic features of all 16 patients with Guillain-Barre syndrome with treatment related fluctuations, of whom 13 were retreated, were compared with those who did not have fluctuations. No significant differences were found between patients with Guillain-Barre syndrome treated with plasma exchange and patients treated with intravenous immune globulins either alone or in combination with high dose methylprednisolone. None of the patients with Guillain-Barre syndrome with preceding gastrointestinal illness, initial predominant distal weakness, acute motor neuropathy, or anti-GM1 antibodies showed treatment related fluctuations. On the other hand patients with fluctuations showed a trend to have the fluctuations after a protracted disease course. It is therefore suggested that treatment related clinical fluctuations are due to a more prolonged immune attack. There is no indication that the fluctuations are related to treatment modality. The results of this study may help the neurologist to identify patients with Guillain-Barre syndrome who are at risk for treatment related fluctuations.
|Keywords||Disease Progression, Drug Therapy, Combination, Humans, Immunoglobulins, Intravenous/*adverse effects, Methylprednisolone/*therapeutic use, Muscle Weakness/diagnosis/*etiology, Plasma Exchange/*adverse effects, Polyradiculoneuropathy/*therapy, Recurrence, Risk Factors, Severity of Illness Index, Treatment Outcome|
Visser, L.H., van der Meché, F.G.A., Meulstee, J., & van Doorn, P.A.. (1998). Risk factors for treatment related clinical fluctuations in Guillain-Barré syndrome. Dutch Guillain-Barré study group. Journal of Neurology, Neurosurgery and Psychiatry: an international peer-reviewed journal for health professionals and researchers in all areas of neurology and neurosurgery. Retrieved from http://hdl.handle.net/1765/8783