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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1998 Aug;65(2):218–224. doi: 10.1136/jnnp.65.2.218

Guillain-Barré syndrome variants in Emilia-Romagna, Italy, 1992-3: incidence, clinical features, and prognosis

E Clinical, E P Neurology
PMCID: PMC2170214  PMID: 9703176

Abstract

OBJECTIVES—To estimate the incidence rate of Guillain-Barré syndrome variants in an unselected population and to describe their clinical features and prognosis.
METHODS—A two year prospective multicentre study on the incidence and prognosis of Guillain-Barré syndrome was performed in Emilia-Romagna, northern Italy (3 909 512 inhabitants). A surveillance system was instituted within the study area, which comprised all the neurological departments, private and public general hospitals, and practising neurologists. The international classification of diseases (ICD) codes 357.XX (any peripheral neuropathy) of hospital discharges were also reviewed.
RESULTS—Data were separately analysed for Miller Fisher syndrome and other Guillain-Barré syndrome variants. During the study period 18 patients with Guillain-Barré syndrome variants including seven with Miller Fisher syndrome were recruited; the incidence rates were 0.14/100 000/year (95% confidence interval (95% CI) 0.07-0.25) for Guillain-Barré syndrome variants (excluding Miller Fisher syndrome) and 0.09/100 000/year (95% CI 0.04-0.18) for Miller Fisher syndrome. Guillain-Barré syndrome variants alone (excluding Miller Fisher syndrome) accounted for 10.5% of total cases. Death and relapses were not found. Details of clinical, electrophysiological, and CSF findings of Guillain-Barré syndrome variants are provided.
CONCLUSIONS—Guillain-Barré syndrome variants other than Miller Fisher syndrome, as obtained through a population based study, account for about 10% of total cases of Guillain-Barré syndrome and, as a whole, have a good prognosis. Their clinical features are heterogeneous; bifacial weakness (associated with other signs, mainly sensory disturbances) represents the most frequent finding.



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Selected References

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  1. Alter M. The epidemiology of Guillain-Barré syndrome. Ann Neurol. 1990;27 (Suppl):S7–12. doi: 10.1002/ana.410270704. [DOI] [PubMed] [Google Scholar]
  2. Asbury A. K., Cornblath D. R. Assessment of current diagnostic criteria for Guillain-Barré syndrome. Ann Neurol. 1990;27 (Suppl):S21–S24. doi: 10.1002/ana.410270707. [DOI] [PubMed] [Google Scholar]
  3. Asbury A. K. Diagnostic considerations in Guillain-Barré syndrome. Ann Neurol. 1981;9 (Suppl):1–5. doi: 10.1002/ana.410090703. [DOI] [PubMed] [Google Scholar]
  4. Beghi E., Bogliun G. The Guillain-Barrè syndrome (GBS). Implementation of a register of the disease on a nationwide basis. Italian GBS Study Group. Ital J Neurol Sci. 1996 Oct;17(5):355–361. doi: 10.1007/BF01999898. [DOI] [PubMed] [Google Scholar]
  5. Beghi E., Kurland L. T., Mulder D. W., Wiederholt W. C. Guillain-Barré syndrome. Clinicoepidemiologic features and effect of influenza vaccine. Arch Neurol. 1985 Nov;42(11):1053–1057. doi: 10.1001/archneur.1985.04060100035016. [DOI] [PubMed] [Google Scholar]
  6. Hallas J., Halls J., Bredkjaer C., Friis M. L. Guillain-Barré syndrome: diagnostic criteria, epidemiology, clinical course and prognosis. Acta Neurol Scand. 1988 Aug;78(2):118–122. doi: 10.1111/j.1600-0404.1988.tb03632.x. [DOI] [PubMed] [Google Scholar]
  7. Kleyweg R. P., van der Meché F. G. Treatment related fluctuations in Guillain-Barré syndrome after high-dose immunoglobulins or plasma-exchange. J Neurol Neurosurg Psychiatry. 1991 Nov;54(11):957–960. doi: 10.1136/jnnp.54.11.957. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Koobatian T. J., Birkhead G. S., Schramm M. M., Vogt R. L. The use of hospital discharge data for public health surveillance of Guillain-Barré syndrome. Ann Neurol. 1991 Oct;30(4):618–621. doi: 10.1002/ana.410300418. [DOI] [PubMed] [Google Scholar]
  9. Lugaresi A., Ragno M., Torrieri F., Di Guglielmo G., Fermani P., Uncini A. Acute motor axonal neuropathy with high titer IgG and IgA anti-GD1a antibodies following Campylobacter enteritis. J Neurol Sci. 1997 Apr 15;147(2):193–200. doi: 10.1016/s0022-510x(96)05349-x. [DOI] [PubMed] [Google Scholar]
  10. McLean M., Duclos P., Jacob P., Humphreys P. Incidence of Guillain-Barré syndrome in Ontario and Quebec, 1983-1989, using hospital service databases. Epidemiology. 1994 Jul;5(4):443–448. doi: 10.1097/00001648-199407000-00011. [DOI] [PubMed] [Google Scholar]
  11. Paolino E., Govoni V., Tola M. R., Casetta I., Granieri E. Incidence of the Guillain-Barré syndrome in Ferrara, northern Italy, 1981-1987. Neuroepidemiology. 1991;10(3):105–111. doi: 10.1159/000110254. [DOI] [PubMed] [Google Scholar]
  12. Radhakrishnan K., el-Mangoush M. A., Gerryo S. E. Descriptive epidemiology of selected neuromuscular disorders in Benghazi, Libya. Acta Neurol Scand. 1987 Feb;75(2):95–100. doi: 10.1111/j.1600-0404.1987.tb07901.x. [DOI] [PubMed] [Google Scholar]
  13. Ropper A. H. Further regional variants of acute immune polyneuropathy. Bifacial weakness or sixth nerve paresis with paresthesias, lumbar polyradiculopathy, and ataxia with pharyngeal-cervical-brachial weakness. Arch Neurol. 1994 Jul;51(7):671–675. doi: 10.1001/archneur.1994.00540190051014. [DOI] [PubMed] [Google Scholar]
  14. Ropper A. H. Unusual clinical variants and signs in Guillain-Barré syndrome. Arch Neurol. 1986 Nov;43(11):1150–1152. doi: 10.1001/archneur.1986.00520110044012. [DOI] [PubMed] [Google Scholar]
  15. Shuaib A., Becker W. J. Variants of Guillain-Barré syndrome: Miller Fisher syndrome, facial diplegia and multiple cranial nerve palsies. Can J Neurol Sci. 1987 Nov;14(4):611–616. [PubMed] [Google Scholar]

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