Guillain-barre Syndrome in Indian Population: A Retrospective Study.

OBJECTIVES: To study clinical characteristics of various forms of Guillain-Barre syndrome in Indian adults. MATERIAL AND METHODS: The epidemiological, clinical, cerebrospinal fluid and electrophysiological data of 65 patients of Guillain-Barre syndrome (GBS) were reviewed in a retrospective study. RESULTS: Analysis of age distribution disclosed a high incidence (36.92%) in young adults between 18 to 29 years of age. Seasonal preponderance in winter and summer was found. Preceding events were identified in 22 (33.84%) cases. Motor weakness, areflexia, and facial weakness were the most common clinical features. Cerebrospinal fluid albuminocytological dissociation was present in 80% of patients. Utilising clinical and electrophysiological data, these 65 patients with Guillain-Barre syndrome were subclassified as acute demyelinating polyradiculoneuropathy 17 (26.15%), axonal form 17 (26.15%), Fisher's syndrome 2 (3.07%)and ataxic variant 1(1.53). The remaining 28 (43.07%) patients were unclassified. 9(13.8%) patients had recurrent GBS. Only 5 (7.7%) patients required mechanical ventilation. Follow up available on 47 patients disclosed that all of them recovered satisfactorily. No patient was persistently disabled and no mortality occurred during hospitalization. CONCLUSIONS: GBS in Indian population from northwest India showed peculiar age, seasonal distribution and high frequency of both AIDP and axonal subtypes. Both, axonal and demyelinating subtypes shared common clinical features and had good prognosis.

Aggressive vertebral hemangioma in the postpartum period: an eye-opener.

Pregnancy is a well-known risk factor for incidental or asymptomatic vertebral hemangiomas becoming aggressive or symptomatic, most often during the third trimester of pregnancy, related to hemodynamic and endocrinal changes occurring during pregnancy. Many patients show spontaneous incomplete remission after delivery. We report a rare case of aggressive vertebral hemangioma in the postpartum period in a 26-year-old woman, who presented with upper backache with progressive spastic paraparesis.

Acute aseptic meningitis due to intravenous immunoglobulin therapy in Guillain-Barré syndrome.

The majority of adverse reactions of intravenous immunoglobulin (IVIG) therapy are mild, transient and self-limiting with potentially serious complications occurring in <5% of patients. IVIG-associated transient aseptic meningitis is one such rare adverse effect, which has been seldomly described in the literature. We report a case of aseptic meningitis due to IVIG therapy in a Guillain-Barré syndrome (GBS) patient. The cerebrospinal fluid analysis revealed high cell counts with predominance of lymphocytic cells, raised protein, normal glucose level and no growth of the organisms on culture. The patient improved with supportive care such as intravenous fluids and analgesics without neurological complications. This case emphasizes the importance of recognizing IVIG-associated complications like aseptic meningitis in GBS patients.