Risk of relapse of Guillain-Barré syndrome or chronic inflammatory demyelinating polyradiculoneuropathy following immunisation
- Department of Neuroimmunology, Guy's, King's & St Thomas' School of Medicine, Hodgkin Building, Guy's Hospital, London SE1 1UL
- Correspondence to: Dr J Pritchard;
- Guillain-Barré syndrome
- chronic inflammatory demyelinating polyradiculoneuropathy
Reports of the rare occurrence of Guillain-Barré syndrome (GBS) or chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) following immunisation1 and recurrence of symptoms following subsequent immunisation2 have given rise to concern over the safety of vaccine administration in this patient group. Similar concerns have been addressed and dismissed in patients with multiple sclerosis,3 but no such information exists for inflammatory neuropathy. To provide more information about vaccine safety in GBS and CIDP we audited the recurrence of neurological symptoms following immunisation.
The Guillain-Barré Syndrome Support Group, a British patient organisation, posted 3000 questionnaires to its members, asking them to identify their illness, record all immunisations administered after their illness, and describe any symptoms within six weeks of immunisation suggestive of recurrence of GBS or worsening of CIDP.
All but one of the patients who reported neurological symptoms after immunisation were contacted by telephone to confirm their history and to grade their symptoms using the modified Rankin scale.4 For the patient who could not be contacted by telephone, the patient's consultant neurologist provided the information. Questionnaires were sent to the general practitioner for each patient who reported a “relapse” to confirm which vaccine had been administered.
A total of 1114 patients (37.1%) completed the questionnaires, of whom 927 had had …