Clinical Features and the Validation of the Brighton Criteria in Guillain-Barré Syndrome: Retrospective Analysis of 72 Hospitalized Patients in Three Years

Abstract

Objective: To analyze the clinical phenotypes and features of Guillain-Barré syndrome (GBS) in our hospital and explore the diagnostic value of the Brighton criteria.

Methods: We retrospectively analyzed the clinical data of GBS patients hospitalized in our hospital from January 1, 2013, to September 30, 2016. The patients were affirmatively graded according to the Brighton criteria (highest: level 1, lowest: level 4).

Result: (1) We enrolled 72 patients with GBS, including 7 with cranial nerve variants, 4 with Miler-Fisher syndrome, and 61 with classic GBS that mainly presented as limb weakness. (2) A total of 56.94% of the included patients had preceding events, of which respiratory tract infections accounted for 63.41%; there was a significant difference in the incidence of GBS across the spring, summer, autumn, and winter. Weakness was the first symptom in 75% of patients, all patients reached peaked within 4 weeks, and 94.44% of the patients presented with decreased or absent deep tendon reflexes. Among the patients who completed a lumbar puncture cerebrospinal fluid (CSF) examination, 73.24% showed proteins dissociated from CSF cells. Demyelinating GBS was found in 54%, and axonal GBS was found in 22% of the patients who completed an electrophysiological examination. All patients with classic GBS were graded according to the Brighton diagnostic criteria as level 1 (60.66%, 37/61), level 2 (34.42%, 21/61), level 3 (4.92%, 3/61), or level 4 (0%).

Conclusion: In our hospital, the clinical features of patients with GBS were similar to those described in previous studies, but demyelinating GBS was the most important subtype. Most preceding events were upper respiratory tract infections. The Brighton criteria were highly sensitive, and perfect clinical data improved diagnostic grading. In areas where medical resources are relatively scarce, a detailed medical history and physical examination can help improve diagnostic accuracy.

Keywords: Brighton criteria; Clinical feature; Clinical phenotypes; Guillain-Barré syndrome.