Guillain-Barré syndrome in the elderly: clinical, electrophysiological, therapeutic and outcome features Síndrome de Guillain-Barré no idoso: aspectos clínico-eletrofisiológicos, terapêutico e prognóstico

There are few papers devoted to geriatric Guillain-Barré (GBS) and many related issues remain unanswered. OBJECTIVE: To describe clinical, electrophysiological and therapeutic features in this age. METHOD: Clinico-epidemiological data and therapy of GBS patients older than 60 years were reviewed. Hu...

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Main Authors: Marcondes C. França Jr, Leonardo Deus-Silva, Rafael de Castro, Solange G. Garibaldi, Beatriz H.M. Pfeilsticker, Anamarli Nucci, José F.C. Marques Jr
Format: Article
Language:English
Published: Thieme Revinter Publicações 2005-09-01
Series:Arquivos de Neuro-Psiquiatria
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Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2005000500010
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author Marcondes C. França Jr
Leonardo Deus-Silva
Rafael de Castro
Solange G. Garibaldi
Beatriz H.M. Pfeilsticker
Anamarli Nucci
José F.C. Marques Jr
author_facet Marcondes C. França Jr
Leonardo Deus-Silva
Rafael de Castro
Solange G. Garibaldi
Beatriz H.M. Pfeilsticker
Anamarli Nucci
José F.C. Marques Jr
author_sort Marcondes C. França Jr
collection DOAJ
description There are few papers devoted to geriatric Guillain-Barré (GBS) and many related issues remain unanswered. OBJECTIVE: To describe clinical, electrophysiological and therapeutic features in this age. METHOD: Clinico-epidemiological data and therapy of GBS patients older than 60 years were reviewed. Hughes scores were used to quantify neurological deficit and define outcome. RESULTS: Among 18 patients (mean age 64.8 years), 9 had evident prodrome and 80% noticed initially sensory-motor deficit. Demyelinating GBS was found in 8 and axonal in 6 subjects. There was one Miller-Fisher and 3 unclassified cases. Plasmapheresis (PFX) was single therapy in 12 patients and intravenous immunoglobulin (IVIg) in 2. Disability scores just before therapy were similar in both groups, so as short and long term outcome. CONCLUSION: Axonal GBS seems to be more frequent in the elderly and this may have prognostic implications. PFX and IVIg were suitable options, but complications were noticed with PFX. Prospective studies are needed to better understand and manage GBS in the elderly.<br>Publicações sobre a síndrome de Guillain-Barré (SGB) no idoso são escassas e várias questões sobre o tema estão abertas. OBJETIVO: Descrever aspectos clínico-eletrofisiológicos, terapêuticos e prognóstico no idoso. MÉTODO:Revisamos os prontuários de pacientes acima de 60 anos com SGB. A escala de Hughes foi usada para quantificar os déficits iniciais e finais. RESULTADOS: No total de 18 pacientes (média de idade 64,8 anos), 50% tiveram pródromo e 80% tiveram déficit sensitivo-motor no início. SGB desmielinizante foi encontrada em 8 pacientes, axonal em 6 e uma síndrome de Miller-Fisher. Três casos não puderam ser classificados. Plasmaférese (PFX) foi empregada isoladamente em 12 pacientes e imunoglobulina endovenosa (IVIg) em 2. A disfunção inicial nos dois grupos tratados era semelhante, assim como a evolução a curto e longo prazo. CONCLUSÃO: A forma axonal da SGB parece ser mais freqüente no idoso e isto pode ter implicações prognósticas. PFX e IVIg foram eficazes, mas complicações ocorreram apenas no grupo tratado com PFX. Estudos prospectivos são necessários para um melhor entendimento e manejo da SGB no idoso.
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spelling doaj-art-71a9cdce96ae4f6ea0ae281a535a4bd32025-08-20T01:58:03ZengThieme Revinter PublicaçõesArquivos de Neuro-Psiquiatria0004-282X1678-42272005-09-01633b77277510.1590/S0004-282X2005000500010Guillain-Barré syndrome in the elderly: clinical, electrophysiological, therapeutic and outcome features Síndrome de Guillain-Barré no idoso: aspectos clínico-eletrofisiológicos, terapêutico e prognósticoMarcondes C. França JrLeonardo Deus-SilvaRafael de CastroSolange G. GaribaldiBeatriz H.M. PfeilstickerAnamarli NucciJosé F.C. Marques JrThere are few papers devoted to geriatric Guillain-Barré (GBS) and many related issues remain unanswered. OBJECTIVE: To describe clinical, electrophysiological and therapeutic features in this age. METHOD: Clinico-epidemiological data and therapy of GBS patients older than 60 years were reviewed. Hughes scores were used to quantify neurological deficit and define outcome. RESULTS: Among 18 patients (mean age 64.8 years), 9 had evident prodrome and 80% noticed initially sensory-motor deficit. Demyelinating GBS was found in 8 and axonal in 6 subjects. There was one Miller-Fisher and 3 unclassified cases. Plasmapheresis (PFX) was single therapy in 12 patients and intravenous immunoglobulin (IVIg) in 2. Disability scores just before therapy were similar in both groups, so as short and long term outcome. CONCLUSION: Axonal GBS seems to be more frequent in the elderly and this may have prognostic implications. PFX and IVIg were suitable options, but complications were noticed with PFX. Prospective studies are needed to better understand and manage GBS in the elderly.<br>Publicações sobre a síndrome de Guillain-Barré (SGB) no idoso são escassas e várias questões sobre o tema estão abertas. OBJETIVO: Descrever aspectos clínico-eletrofisiológicos, terapêuticos e prognóstico no idoso. MÉTODO:Revisamos os prontuários de pacientes acima de 60 anos com SGB. A escala de Hughes foi usada para quantificar os déficits iniciais e finais. RESULTADOS: No total de 18 pacientes (média de idade 64,8 anos), 50% tiveram pródromo e 80% tiveram déficit sensitivo-motor no início. SGB desmielinizante foi encontrada em 8 pacientes, axonal em 6 e uma síndrome de Miller-Fisher. Três casos não puderam ser classificados. Plasmaférese (PFX) foi empregada isoladamente em 12 pacientes e imunoglobulina endovenosa (IVIg) em 2. A disfunção inicial nos dois grupos tratados era semelhante, assim como a evolução a curto e longo prazo. CONCLUSÃO: A forma axonal da SGB parece ser mais freqüente no idoso e isto pode ter implicações prognósticas. PFX e IVIg foram eficazes, mas complicações ocorreram apenas no grupo tratado com PFX. Estudos prospectivos são necessários para um melhor entendimento e manejo da SGB no idoso.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2005000500010síndrome de Guillain-Barréplasmaféreseimunoglobulina endovenosaidososGuillain-Barré syndromeplasmapheresisintravenous immunoglobulinelderly
spellingShingle Marcondes C. França Jr
Leonardo Deus-Silva
Rafael de Castro
Solange G. Garibaldi
Beatriz H.M. Pfeilsticker
Anamarli Nucci
José F.C. Marques Jr
Guillain-Barré syndrome in the elderly: clinical, electrophysiological, therapeutic and outcome features Síndrome de Guillain-Barré no idoso: aspectos clínico-eletrofisiológicos, terapêutico e prognóstico
Arquivos de Neuro-Psiquiatria
síndrome de Guillain-Barré
plasmaférese
imunoglobulina endovenosa
idosos
Guillain-Barré syndrome
plasmapheresis
intravenous immunoglobulin
elderly
title Guillain-Barré syndrome in the elderly: clinical, electrophysiological, therapeutic and outcome features Síndrome de Guillain-Barré no idoso: aspectos clínico-eletrofisiológicos, terapêutico e prognóstico
title_full Guillain-Barré syndrome in the elderly: clinical, electrophysiological, therapeutic and outcome features Síndrome de Guillain-Barré no idoso: aspectos clínico-eletrofisiológicos, terapêutico e prognóstico
title_fullStr Guillain-Barré syndrome in the elderly: clinical, electrophysiological, therapeutic and outcome features Síndrome de Guillain-Barré no idoso: aspectos clínico-eletrofisiológicos, terapêutico e prognóstico
title_full_unstemmed Guillain-Barré syndrome in the elderly: clinical, electrophysiological, therapeutic and outcome features Síndrome de Guillain-Barré no idoso: aspectos clínico-eletrofisiológicos, terapêutico e prognóstico
title_short Guillain-Barré syndrome in the elderly: clinical, electrophysiological, therapeutic and outcome features Síndrome de Guillain-Barré no idoso: aspectos clínico-eletrofisiológicos, terapêutico e prognóstico
title_sort guillain barre syndrome in the elderly clinical electrophysiological therapeutic and outcome features sindrome de guillain barre no idoso aspectos clinico eletrofisiologicos terapeutico e prognostico
topic síndrome de Guillain-Barré
plasmaférese
imunoglobulina endovenosa
idosos
Guillain-Barré syndrome
plasmapheresis
intravenous immunoglobulin
elderly
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2005000500010
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