Is Guillain-Barré syndrome different in Pakistan?

Objective: To assess clinical presentations and subtypes of Guillain-Barré Syndrome (GBS) in Pakistan. Study Design: Retrospective study. Place and Duration of Study: CMH Lahore, Abbotabad, Quetta & Armed Forces Institute of Rehabilitation Medicine form Jan 2007 to Feb 2015. Material and Methods: The relevant history, demographic features, clinical presentations and subtypes of GBS in 211 patients fulfilling the clinical and electrodiagnostic criteria were investigated. Results: The average age of the patients was 37.36 years (62.7% M, 37.3% F). Clinically 66.8%, 17.8% and 15.4% presented as ascending paralysis, simultaneous quadriparesis and paraparesis respectively. About 38.1% of the patients presented with cranial nerves involvement, 87.4% presented with areflexia while 59.5% reported pain. The GBS subtypes identified were acute inflammatory demyelinating polyneuropathy (21.9%), acute motor axonal neuropathy (38.9%), acute motor sensory axonal neuropathy (35.6%) and fisher syndrome (3.6%). Conclusion: The GBS presents in young, as an ascending paralysis, main subtypes of GBS in Pakistan are axonal and this highlights the importance of local management guidelines and preventive medicine. (author)