Český národní registr Guillainova-Barrého syndromu

Introduction: The Guillain-Barre syndrome is an acute inflammatory autoimmune polyradiculo-neuropathy and belongs among rare neurologic diseases. Since poliomyelitis has been almost completely eliminated, it is currently the most frequent cause of acute flaccid paralysis worldwide. The registry was formed in the Czech Republic in 2012 and is an important source of prospectively recorded data. Aim: The goal of the registry is to follow up the clinical profile, treatment and 6-month prognosis of Guillain-Barre syndrome patients. Methods: The data are collected prospectively by persons delegated by neuromuscular centres in the Czech Republic. The clinical course is assessed on the basis of the GBS disability scale and muscle strength according to the Medical Research Council sum score for facial muscles and extremity muscles. Detailed clinical investigation is done on admission, before the treatment, immediately after the treatment, 1 month and 6 months after the end of the treatment. Results: We enrolled a total 272 cases of Guillain-Barre syndrome patients in the period from 1st January 2012 to 17th August 2016. We have complete data for 6 months in 137 of them. 52 were treated with intravenous human immunoglobulin and 85 with plasma exchange. A good clinical outcome after 6 months (ability to walk unassisted) was achieved in 85% of patients. Severe residual neurological deficit persisted after 6 months in 11% of patients. The remaining 6 patients died. We did not find any difference in the efficiency of immunoglobulin vs. plasma exchange in the whole group, in the subgroup of the severely disabled patients and according to sex. Conclusion: Medical care centralisation and adherence to the standard of care lead to a good clinical outcome in Guillain-Barre syndrome patients, which is comparable with relevant sources.