A study on topographic variants of Guillain-Barré Syndrome in a tertiary care hospital in South India

Background: The first clinical description of GBS dates back to 1859 by Jean Baptiste Octave Landry. It was further characterised by George Guillain and Jean Alexandre Barré and simultaneously by Andre Strohl in 1916 Objective: To report the frequency of occurrence of topographic variants of Guillain-Barré Syndrome (GBS) among patients attending tertiary teaching government hospital, Hyderabad, Telangana. Material and methods: We have analyzed 746 consecutive patients admitted for acute onset rapidly progressive weakness in our Institute from May 2010 to July 2015. GBS was diagnosed as per NINDS criteria and GBS variants as per Asbury’s and other investigators criteria described vide infra. Results: Out of 746 patients, only 668 were diagnosed GBS as per NINDS criteria. Among 668 GBS patients, only 47 were identified as topographic subtypes of GBS. The Electrodiagnostic subtypes identified were AIDP 347 (56%); AMSAN 127 (20%); AMAN 85 (14%) and 62 (10%) of the patients were ‘Equivocal’. Among the topographic subtypes GBS patients, 28/47 Paraparetic Variant; 8/47 PCB Variant; 6/47 Miller Fischer Variant; 3/47 Facial Diplegia; 2/47 Pure Sensory variants were identified. Conclusion: Topographic variants GBS accounted for 7% of GBS patients in our institute. Paraparetic variant was more common among our population and had a better prognosis. PCB Variant had poorer outcome. There was strong association with antecedent infection. There were some seasonal trends with predilection in winter and rainy seasons.