Guillain-Barré syndrome in a local area in Japan, 2006-2015: An epidemiological and clinical study of 108 patients.

Background and purposeMany epidemiological studies of Guillain-Barre syndrome (GBS) and Fisher syndrome (FS) have been conducted in Europe and America. In contrast, epidemiological studies are rare in Asia where the GBS subtypes differ from those in Western countries. This study was undertaken to clarify the incidence of GBS and FS in a local area in Japan as well as their seasonal trends. MethodSeventy-one GBS and 37 FS patients were recorded from 2006 to 2015 in an area of approximately 1.5 million inhabitants in Japan. The incidence, seasonal trends and clinical features of GBS and FS were examined. ResultsThe incidence rate of GBS was 0.42 cases per 100000 person-years and that of FS was 0.22 cases per 100000 person-years. The incidence of GBS increased with age and FS affected predominantly patients aged from 45 to 64years old. There was some seasonal clustering of acute motor axonal neuropathy (AMAN) and FS in spring and summer, but it was not significant. AMAN and FS patients had a high frequency of preceding infection (AMAN, 68% gastrointestinal infection; FS, 65% upper respiratory infection). Antecedent respiratory infection was significantly associated with FS as an outcome. Serum antibodies to ganglioside GM1 were detected in 71% of AMAN patients and antibodies to GQ1b were detected in 81% of FS patients. ConclusionsOur study offers evidence of a lower incidence of GBS and a higher incidence of FS in a local area in Japan than in Western countries.