[Treatment of Guillain-barre syndrome: immunoglobulins or plasmapheresis?]. / Tratamiento del síndrome de Guillain-Barré: inmunoglobulinas o plasmaféresis?

The aim of this study was to compare the efficacy of IgIV versus plasmapheresis in the treatment of Guillain-Barré syndrome. Twenty-four Guillain-Barré patients were treated either with IgIV (n = 17), or plasmapheresis (n = 7). Evolution during the first year after onset were assessed using the motor functional scale of Hughes and nerve conduction studies. IgIV treated patients had better functional recovery than the plasmapheresis group (p < 0.05) and shorter hospital stays (p < 0.05). These differences were significant from day 30 after treatment. Complications occurred in 14 patients: 9 (58%) in the IgIV group, and 5 (71%) in the patients treated with plasmapheresis. IgIV treated patients had better functional recovery scores and shorter hospital stays. There were no differences in the complication rates. Therefore we believe that IgIV is the treatment of choice for Guillain-Barré syndrome in our clinical setting.

Peduncular hallucinosis associated with posterior thalamic infarction.

Peduncular hallucinations are generally associated with lesions of the midbrain. We describe a 68-year-old man who developed left hemiparesis, paraesthesias on the left side and vivid visual hallucinations, suggesting peduncular hallucinosis. MRI demonstrated a right posterior thalamic infarct as the sole lesion.