Post-Infective Polyneuritis: A Record Study (2005 - 2009)

Abstract

Background: Post-infective polyneuritis, also known as Guillain-Barre syndrome (GBS), is a rare and rapidly progressive immune-mediated disorder that consists of inflammation of nerves and usually causes the muscle weakness, sometimes progressing to complete paralysis. Objective: This retrospective study was undertaken to assess the incidence, management and outcome of post-infective polyneuritis in District Faisalabad, Pakistan. Methods: We reviewed all the 67 cases, 47 males and 20 females, who were admitted to the ICU of the Allied Hospital, Faisalabad during 2005-2009, and diagnosed as post-infective polyneuritis. The management comprised of treatment of the complications of the disease, and the specific therapy with plasmapheresis or high-dose immunoglobulin.  Six  paediatric  cases   were   also admitted; two of them were found to be suffering from   poliomyelitis.    Thirteen   cases of  muscular weakness due to hypokalaemia mimicked the diagnosis of GBS. Results: The specific therapy involving plasmapheresis or immunoglobulin resulted in (i) fewer patients needing mechanical ventilation, (ii) the decreased duration of mechanical ventilation, and (iii) reduction in the time needed for motor recovery and walking without assistance. Conclusion: Early referral to ICU, management of complications, good nursing care and specific therapy with plasmaphresis or immunoglobulin within seven days of onset of the symptoms improve prognosis.