Cardiovascular autonomic assessment in guillain-barre syndrome: A longitudinal study
Document Type
Article
Publication Date
9-1-2022
Abstract
Background: Severe dysautonomia is typically seen during acute phase of Guillain-Barre syndrome (GBS). Objective: To investigate the relationship of cardiovascular autonomic dysfunction with motor recovery in GBS. Materials and Methods: Consecutive GBS patients presented to our hospital were recruited. Clinical assessment was evaluated with the Medical Research Council (MRC) sum score and GBS disability score (GDS). All patients had series of autonomic testing on admission and after treatment at 6 and 24 weeks. Both computation-dependent tests (heart rate variability HRV] and baroreflex sensitivity BRS]) and autonomic maneuvers were performed. Age- and gender-matched healthy controls (HC) were recruited. The data obtained at admission, 6 weeks and 24 weeks were compared within groups for statistical difference. Results: Six patients (4 men; mean age 39.5 +/- 14.3 years) were recruited over one year. Five had GBS and one Miller Fisher syndrome. The mean MRC sum score and GDS on admission were 52.3 +/- 4.3 and 3.5 +/- 0.8 respectively. During admission, time-domain average RR interval (AVNN) and BRS were significantly poorer among cases compared to HC. Active standing 30:15 ratio and cold pressor test at admission were also significantly abnormal when compared with HC. All the autonomic parameters had normalized by 6 weeks and these were significant for the high frequency-HRV, BRS, and active standing 30:15 ratio. For MRC and GDS, there were significant improvements in the scoring over a period of 24 weeks. Conclusions: Dysautonomia in GBS improved gradually and in keeping with motor and disability recovery.
Keywords
Autonomic dysfunction, Baroreflex sensitivity, Dysautonomia, Guillain-Barre syndrome, Heart rate variability
Divisions
medicinedept
Funders
Universiti Malaya [Grant No: BK074-2017]
Publication Title
Neurology India
Volume
70
Issue
5
Publisher
Wolters Kluwer Medknow Publications
Publisher Location
WOLTERS KLUWER INDIA PVT LTD , A-202, 2ND FLR, QUBE, C T S NO 1498A-2 VILLAGE MAROL, ANDHERI EAST, MUMBAI, Maharashtra, INDIA