Abstract Details

Title Autonomic Dysfunction in Patients with Guillain-Barré Syndrome and Related Prognosis: From the Clinic to the Electrophysiology.

Topic Neuromuscular and Clinical Neurophysiology (EMG)

Presentation(s) P8 - Poster Session 8 (11:45 AM-12:45 PM)

Poster/Presentation
Number 11-003

Objective

To evaluate the dysautonomia spectrum in GBS patients, its relationship with outcome, and comparison with those without autonomic disturbances.

Background

Guillain–Barre syndrome (GBS) presents an annual incidence of 1.2 – 2.3 per 100,000. Sympathetic and parasympathetic nervous system peripheral control of visceral organs is affected by GBS aberrant immune response. Associated cardiovascular, gastrointestinal, sudomotor, pupillary, and other system disturbances cause significant morbidity and mortality.

Design/Methods

We performed a longitudinal and ambispective review study of patients with GBS and dysautonomia admitted to the National Institute from 2017 to 2020. We recorded demographics, comorbidities, nerve conduction studies (NCS), clinical course, hospital complications, and functional outcomes.

Results We included 214 patients, mean age 46.44±16.49 years, 51 (31%) presented dysautonomia; hypertension in most of the patients (84.8%). 39.2% had a demyelinating variant and 39.2% an axonal variant. Hypotension (76.1%), tachycardia (76.1%), constipation (76.1%), gastric dysmotility (58.7%), and vasopressor requirement (58.7%) were common characteristics. Factors associated with dysautonomia were lower cranial nerve (VII, IX, X) involvement, mechanical ventilation, intensive care unit requirement, higher mEGOS, EGRIS and GDS scores, and presence of dellirium. Dysautonomic patients required more days to achieve independent walking. There was no associated mortality.

Conclusions

Autonomic dysfunction in GBS represents a severe damage to the peripheral nervous system, with consequently worse functional outcomes. Further investigation is needed to clarify whether more aggressive treatment is beneficial in this subset of GBS cases.

Authors/Disclosures
Anna L. Bazan, MD (Instituto Nacional de Neurologia) PRESENTER	Dr. Bazan has nothing to disclose.
	No disclosure on file
	No disclosure on file
Adib Jorge De Sarachaga, MD (Instituto Nacional De Neurologia Y Neurocirugia Manuel Velasco Suarez)	Dr. Jorge De Sarachaga has nothing to disclose.
	No disclosure on file
Elizabeth Leon	Elizabeth Leon has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for BIOGEN AND SANOFI.
Edwin S. Vargas, MD (National Institute of Neurology, Mexico)	Dr. Vargas has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Sanofi. Dr. Vargas has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for CSL Berhing.

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