Epidemiology and characteristics of Guillain-Barre syndrome in the northwest of Iran

BACKGROUND: Little is known about the incidence of Guillain-Barre syndrome (GBS) in Iran. We determined the incidence and evaluated prognostic factors for GBS in a prospective, population-based study. PATIENTS AND METHODS: We evaluated and followed all patients with a diagnosis of GBS admitted to three referral neurology centers in East Azerbaijan province over a 1-year period (2003). Clinical and electrophysiological characteristics of cases were reviewed and analyzed. RESULTS: A total of 76 patients were found, corresponding to a crude annual incidence rate of 2.11/100 000 population. Six patients (7.9%) died acutely within 21 days from the onset of the disease. Acute mortality was due to respiratory involvement, sepsis and acute autonomic system dysfunction. The persistence of disability after the acute phase was related to axonal involvement (OR = 319, 95% CI, 1.65 to 6.16). There was a significant correlation between a history of diarrhea and a further need for mechanical ventilation (P < 0.05). Mechanically ventilated patients had a low GBS disability score on discharge compared with patients not mechanically ventilated (P = 0.05). CONCLUSIONS: The incidence rates of GBS in our province is similar to that in other countries. Acute mortality in GBS was mostly due to poor respiratory care of patients and infective complications, but disability and probably late mortality were due to axonal nerve injury.