Guillain Barre Sendromunda Klinik Özellikler ve Prognoz

TOMAK, Tezcan; Gazioglu, Sibel; Boz, Cavit

Guillain Barre Sendromunda Klinik Özellikler ve Prognoz

SİBEL GAZİOĞLU, (Karadeniz Teknik Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, Trabzon, Türkiye)

Tezcan TOMAK, (Karadeniz Teknik Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, Trabzon, Türkiye)

Cavit BOZ (Karadeniz Teknik Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, Trabzon, Türkiye)

Journal of Neurological Sciences (Turkish)

46 3

Yıl: 2013 Cilt: 30 Sayı: 1 Sayfa Aralığı: 124 - 134 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Guillain Barre Sendromunda Klinik Özellikler ve Prognoz

Öz:

Amaç: Bu çalışmada Guillain Barre Sendrom'lu (GBS) hastaların epidemiyolojik, klinik,laboratuvar ve elektrofizyolojik özellikleri ve bu parametrelerin hastalığın prognozu ile olanilişkisini retrospektif olarak araştırdık.Metod: Ocak 2001 ve Ocak 2012 tarihleri arasında Nöroloji kliniğimizde GBS tanısı ileyatırılan hastaların dosya kayıtları retrospektif olarak incelendi.Sonuç: GBS tanısı alan 64 hastanın 40'ı erkek (ortalama yaş 50; aralık 17-79) , 24'ü (ortalamayaş 45; aralık 20-76) kadındı. Klinik ve elektrofizyolojik verilerine göre hastaların %70.3'üakut inflamatuar demyelinizan polinöropati (AIDP), %15.6'sı akut motor aksonal nöropati,%9.4'ü akut motor ve duyusal aksonal nöropati ve %4.7'si Miller Fisher Sendromu olarakdeğerlendirildi. GBS aksonal formlarının kas kuvvetlerinin ve GBS skorlarının AIDP'lihastalara göre daha kötü olduğu tespit edildi (p<0.05). 30 hastanın taburculuktan sonrakontrol muayene bilgileri mevcuttu. Ortalama 12 ay (aralık 8-34 ay) sonraki kontrolde buhastaların %80'i (24/30) desteksiz yürüyebilirken, 20 hastanın (%66.6) tamamen semptomsuzveya minimal semptomları mevcuttu. Hastaların Medikal Araştırma Kurulu (MRC) toplamskorlarının prognoz ile anlamlı bir korelasyonu mevcuttu (p<0.001, r>0.75). Otonom sistemtutulum belirtilerinin olması, mekanik ventilasyon ihtiyacı duyacak düzeyde solunum sıkıntısıgözlenmesi ile elektromyografide aksonal tutulum ve aksonal formların kötü prognoz ileilişkili olduğu tespit edildi (p<0.05).Tartışma: GBS'nun çalışmamızda tespit edilen demografik, klinik ve elektrofizyolojiközellikleri literatür ile uyumlu idi. Aksonal tutulum, otonomik bozukluk, mekanik ventilasyonihtiyacı duyacak düzeyde solunum sıkıntısı ve ağır kas kuvvetsizliğinin kötü prognostikfaktörler olduğu dikkate alınarak klinik yaklaşımın yönlendirilmesi hasta takibi ve tedaviplanlanmasına katkıda bulunacaktır.

Anahtar Kelime:

Konular: Tıbbi Araştırmalar Deneysel Anestezi Üroloji ve Nefroloji

Clinical Characteristics and Prognosis of Guillain Barre Syndrome

Öz:

Objective: We retrospectively investigated the epidemiological, clinical, laboratory andelectrophysiological features of patients with Guillain Barre Syndrome (GBS) and theirrelationship with prognosis.Methods: We reviewed the medical records of patients hospitalized with the diagnosis ofGBS at our neurology clinic from January 2001 through January 2012.Results: Sixty-four patients with the diagnosis of GBS included 40 males (mean age 50;range 17-79) and 24 (mean age 45; range 20-76) females. Based on clinical andelectrophysiological features, 70.3% of the patients had acute inflammatory demyelinatingpolyneuropathy (AIDP), 15.6% had acute motor axonal neuropathy, 9.4% had acute motorand sensory axonal neuropathy and 4.7% had Miller Fisher Syndrome. GBS scores andmuscle forces of the patients with axonal forms were worse than those of the patients withAIDP (p<0.05). Thirty patients had medical records of control examinations after discharge.Eighty percent (24/30) of these patients were able to walk without aid, and 20 patients(66.6%) had minimal or no symptoms after approximately 12 months (range 8-34 months).Patients' Medical Research Council (MRC) sum-scores exhibited a significant correlationwith prognosis (p<0.001, r>0.75). Findings of autonomic involvement, respiratory distressrequiring mechanical ventilation, axonal findings on electromyography and axonal formswere associated with poor prognosis (p<0.05).Conclusions: The demographic, clinical and electrophysiological features of GBS in ourstudy were consistent with the literature. A clinical approach based on awareness that axonalinvolvement, autonomic dysfunction, respiratory distress requiring mechanical ventilation andsevere muscle weakness are poor prognostic factors will contribute to patient care andplanning of treatment.

Anahtar Kelime:

Konular: Tıbbi Araştırmalar Deneysel Anestezi Üroloji ve Nefroloji

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	Gazioglu S, TOMAK T, Boz C (2013). Guillain Barre Sendromunda Klinik Özellikler ve Prognoz. , 124 - 134.
Chicago	Gazioglu Sibel,TOMAK Tezcan,Boz Cavit Guillain Barre Sendromunda Klinik Özellikler ve Prognoz. (2013): 124 - 134.
MLA	Gazioglu Sibel,TOMAK Tezcan,Boz Cavit Guillain Barre Sendromunda Klinik Özellikler ve Prognoz. , 2013, ss.124 - 134.
AMA	Gazioglu S,TOMAK T,Boz C Guillain Barre Sendromunda Klinik Özellikler ve Prognoz. . 2013; 124 - 134.
Vancouver	Gazioglu S,TOMAK T,Boz C Guillain Barre Sendromunda Klinik Özellikler ve Prognoz. . 2013; 124 - 134.
IEEE	Gazioglu S,TOMAK T,Boz C "Guillain Barre Sendromunda Klinik Özellikler ve Prognoz." , ss.124 - 134, 2013.
ISNAD	Gazioglu, Sibel vd. "Guillain Barre Sendromunda Klinik Özellikler ve Prognoz". (2013), 124-134.

APA	Gazioglu S, TOMAK T, Boz C (2013). Guillain Barre Sendromunda Klinik Özellikler ve Prognoz. Journal of Neurological Sciences (Turkish), 30(1), 124 - 134.
Chicago	Gazioglu Sibel,TOMAK Tezcan,Boz Cavit Guillain Barre Sendromunda Klinik Özellikler ve Prognoz. Journal of Neurological Sciences (Turkish) 30, no.1 (2013): 124 - 134.
MLA	Gazioglu Sibel,TOMAK Tezcan,Boz Cavit Guillain Barre Sendromunda Klinik Özellikler ve Prognoz. Journal of Neurological Sciences (Turkish), vol.30, no.1, 2013, ss.124 - 134.
AMA	Gazioglu S,TOMAK T,Boz C Guillain Barre Sendromunda Klinik Özellikler ve Prognoz. Journal of Neurological Sciences (Turkish). 2013; 30(1): 124 - 134.
Vancouver	Gazioglu S,TOMAK T,Boz C Guillain Barre Sendromunda Klinik Özellikler ve Prognoz. Journal of Neurological Sciences (Turkish). 2013; 30(1): 124 - 134.
IEEE	Gazioglu S,TOMAK T,Boz C "Guillain Barre Sendromunda Klinik Özellikler ve Prognoz." Journal of Neurological Sciences (Turkish), 30, ss.124 - 134, 2013.
ISNAD	Gazioglu, Sibel vd. "Guillain Barre Sendromunda Klinik Özellikler ve Prognoz". Journal of Neurological Sciences (Turkish) 30/1 (2013), 124-134.