J Neurol Neurosurg Psychiatry 1998;64:74-77 ( January )

Epidemiological study of Guillain-Barré syndrome in south east England

J H Rees,^a R D Thompson,^a N C Smeeton,^b R A C Hughes^a

^a Department of Neurology, ^b Department of Public Health Medicine, UMDS Guy's Hospital, St Thomas' Street, London, UK

Correspondence to: Professor R A C Hughes, Department of Neurology, UMDS Guy's Hospital, St Thomas' Street, London SE1 9RT, UK.

Received 25 March 1997 and in revised form 1 September 1997; Accepted 17 September 1997

OBJECTIVESTo determine the incidence, treatment, and outcome of Guillain-Barré syndrome in south east England.
METHODSPatients presenting with confirmed Guillain-Barré syndrome between 1 July 1993 and 30 June 1994 were recruited via a voluntary reporting scheme coordinated by the British Neurological Surveillance Unit, hospital activity data collected from acute admitting hospitals within the South East and South West Thames Regional Health Authorities, death certificates, and a contemporary research study of Guillain-Barré syndrome and Campylobacter jejuni infection. All patients were followed up for one year to determine outcome.
RESULTSSeventy nine patients were recruited, 35 (44%) male, 44 (56%) female, including three children (two boys, one girl). The crude (95% confidence interval (95% CI)) annual incidence was 1.2 (0.9-1.4) cases/100 000 population and 1.5 (1.3-1.8)/100 000 when adjusted for undetected cases. Twenty (25%) patients required ventilation for an average (SD) of 42 (64) days. Thirty six (46%) patients received intravenous human immunoglobulin, five (6%) received plasma exchange, 11 (14%) both treatments, three (4%) steroids, and 25 (32%) no immunomodulatory treatment. One year later, six patients (8%) had died, all of whom were older than 60, three (4%) remained bedbound or ventilator dependent, seven (9%) were unable to walk unaided, 14 (17%) were unable to run, and 49 (62%) had made a complete or almost complete recovery. Increasing age was significantly associated with a poorer outcome at one year.
CONCLUSIONSDespite the frequent use of modern immunomodulatory treatments Guillain-Barré syndrome still carries considerable morbidity and mortality.

Keywords: Guillain-Barré syndrome; epidemiology; prognosis

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© 1998 by Journal of Neurology, Neurosurgery, and Psychiatry
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