RESUMO
INTRODUCTION: Plasmapheresis is an important modality for the treatment of GBS. Moreover the response to this treatment modality is not same in all cases. We therefore studied the various prognostic indicators of response to plasmapheresis in patients of Guillain Barre Syndrome. MATERIAL AND METHODS: 40 patients were included in the study. Thorough clinical examination was done. Nerve conduction was done to find out the type of neuropathy. All were then given plasmapheresis. Prognostic indicators with reference to Age, sex, presenting severity, time between onset of illness and arrival to hospital, time taken to start plasmapheresis, number of plasmapheresis cycles, respiratory involvement, and type of neuropathy were studied. RESULTS: There were 57.5% females and 47.5% males. Majority (82%) patients were in the age group of 20 to 60 years. All the patients had power grade 1 or 2 on admission but on discharge the power was grade 3 to 5 in 29 (80.55%) patients. The number of patients who received 5 cycles was 34(85%) and those who received 4 cycles of plasmapheresis was 6(15%). AIDP (acute inflammatory demyelinating polyneuropathy) was seen in 36 (90%) pts and AMAN (Acute Motor axonal Neuropathy) was seen in 4 (10%) patients. The severity at presentation and improvement was similar for all ages. Those who received plasmapheresis late showed power improvement of 2 to 3 grade in (50%) whereas those who received early showed improvement of 2 or 3 grade power in 82.14% patients indicating better improvement with early plasmapheresis. No difference was seen in grade of power improvement in 4 or 5 cycles of plasmapheresis. The number of patients on mechanical ventilation were 13 (40.62%) AIDP cases and 4 (100%) AMAN cases indicating more respiratory involvement in AMAN patients. All four patients of AMAN put on mechanical ventilation died of Ventilator associated pneumonia. CONCLUSIONS: Early treatment with plasmapheresis has better outcome in patients of GBS.four and five cycles of plasmapheresis are equally beneficial.