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Abstract Details

Demyelinating Features More Common in Recurrent Guillain-Barré Syndrome: is Monophasic GBS a Different Disease?
Neuromuscular and Clinical Neurophysiology (EMG)
P10 - Poster Session 10 (8:00 AM-9:00 AM)

The prevalence of recurrent GBS (rGBS) is estimated at 5-6%. There is no information regarding clinical characteristics and prognosis in Latin American patients with rGBS1.

To compare demographics, clinical presentation, severity, nerve conduction studies and acute treatment response in patients with recurrent vs monophasic GBS.

A cross-sectional and comparative study was carried out with consecutive Mexican patients diagnosed with recurrent or monophasic GBS from January 2015 to May 2021. Demographics (gender, age, symptom-to-arrival, previous history of respiratory or gastrointestinal infection), seasonal presentation, MRC score, EGRIS, mEGOS, GBS disability score (GDS), clinical presentation and lumbar puncture were obtained at ER arrival. Electrophysiological variants were classified according to Hadden et al2. Acute immunomodulatory treatment, mortality and in-hospital complications were assessed.  

A total of 225 patients (211 monophasic and 14 recurrent) were included. rGBS prevalence was 6.2%, with a mean time between episodes of 15.1±12.4 years. Symptom-to-arrival time was shorter (3.7±2.0 vs 6.7±4.8 days, p=0.001) and more patients had a previous gastrointestinal infection in the rGBS group (50% vs 36.0%, p=0.29). No significant differences were observed in clinical presentation or severity. Demyelinating variant was more common in rGBS (81.8% vs 45.8%, p=0.028); with greater prolonged distal latencies (5.3±1.0 vs 4.8±3.6 ms, p=0.046), decreased velocities (41.8±14.8 vs 46.2±20.2 m/s, p=0.036) and prolonged F wave latencies for the left median nerve (24.3±17.7 vs 15.2±17.4 ms, p=0.044) in the rGBS group. There were no differences in mortality or in-hospital complications.

Demyelinating variant is more common in rGBS, although clinical presentation and acute treatment response are similar to monophasic GBS. Demyelinating features might play a role in promoting recurrence. 



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
No disclosure on file
Anna L. Bazan, MD (Instituto Nacional de Neurologia) Dr. Bazan has nothing to disclose.
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.