Frequency of Autonomic Dysfunction in Patients with Guillain Barre Syndrome

Authors

  • Sana Khalid Department of Neurology, Mayo Hospital, Lahore, Punjab, Pakistan.
  • Ayesha Aslam Department of Neurology, Mayo Hospital, Lahore, Punjab, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i7.2082

Keywords:

Guillain-Barre Syndrome (GBS), Autonomic Dysfunction (AD), Frequency, Outcomes

Abstract

Background and Aim: Guillain-Barre syndrome (GBS) described as a syndrome manifesting clinically as an acute inflammatory polyradiculoneuropathy (AIDP) with concomitant, symmetrical muscular weakness with absent or diminished deep tendon reflexes. Autonomic dysfunction (AD) is frequent and clinically important complication of GBS, which potentially contributes to adequate sickness and even mortality. The present study aimed to determine the frequency of AD in GBS patients. Patients and Method: This cross-sectional study investigated 100 patients presenting with new onset Guillain Barre Syndrome in the department of Neurology, Mayo Hospital, Lahore from October 2024 to April 2025. Patients aged 18-65 years of either gender presented with new onset GBS were enrolled.  Diagnosis of GBS was established through clinical assessment and supported by relevant investigations, including cerebrospinal fluid analysis and nerve conduction studies. Demographic information and illness duration recorded. All patients were evaluated for the presence of autonomic dysfunction (AD) using a standardized operational definition. Data analysis done using SPSS version 27. Results: The overall mean age was 37.82±4.62 years. Among the 100 patients diagnosed with Guillain-Barre syndrome, autonomic dysfunction (AD) seen in 38% of cases. The most common manifestations of AD included fluctuation in blood pressure (26%), cardiac arrhythmia (18%), and urinary retention (12%). AD seen more often in patients over 40 years of age and in patients with severe motor weakness. No significant gender-based differences in the frequency of AD observed. Conclusion: Autonomic dysfunction (AD) represents a frequent and significant complication in Guillain-Barre syndrome, affecting over one-third of affected individuals. Timely recognition and monitoring of autonomic symptoms are vital, as they play an important role in determining clinical outcomes and are associated with high risks of morbidity and mortality.

Downloads

Download data is not yet available.

References

1. Singh, J., Raja, V., Irfan, M., Hashmat, O., Syed, M., & Shahbaz, N. N. (2020). Frequency of autonomic dysfunction in patients of guillain Barre syndrome in a tertiary care hospital. Cureus, 12(12).

https://doi.org/10.7759/cureus.12101

2. Yuki, N., & Hartung, H. (2012). Guillain–Barre syndrome. New England Journal of Medicine, 366(24), 2294-2304.

https://doi.org/10.1056/nejmra1114525

3. Landaverde, J., Danovaro‐Holliday, M., Trumbo, S., Pacis‐Tirso, C., & Ruiz‐Matus, C. (2010). Guillain‐Barre syndrome in children aged <15 years in Latin America and the Caribbean: Baseline rates in the context of the influenza A (H1N1) pandemic. The Journal of Infectious Diseases, 201(5), 746-750.

https://doi.org/10.1086/650530

4. Sejvar, J. J., Baughman, A. L., Wise, M., & Morgan, O. W. (2011). Population incidence of Guillain-Barre syndrome: A systematic review and meta-analysis. Neuroepidemiology, 36(2), 123-133.

https://doi.org/10.1159/000324710

5. Fontes, C. A., Dos Santos, A. A., & Marchiori, E. (2016). Magnetic resonance imaging findings in Guillain-Barre syndrome caused by Zika virus infection. Neuroradiology, 58(8), 837-838.

https://doi.org/10.1007/s00234-016-1687-9

6. Fokke, C., Van den Berg, B., Drenthen, J., Walgaard, C., Van Doorn, P. A., & Jacobs, B. C. (2013). Diagnosis of Guillain-Barre syndrome and validation of Brighton criteria. Brain, 137(1), 33-43.

https://doi.org/10.1093/brain/awt285

7. Alshekhlee, A., Hussain, Z., Sultan, B., & Katirji, B. (2008). Guillain–barré syndrome. Neurology, 70(18), 1608-1613.

https://doi.org/10.1212/01.wnl.0000310983.38724.d4

8. Ye, Y., Wang, K., Deng, F., & Xing, Y. (2012). Electrophysiological subtypes and prognosis of Guillain–Barre syndrome in northeastern China. Muscle & Nerve, 47(1), 68-71.

https://doi.org/10.1002/mus.23477

9. Bazán-Rodríguez, A. L., Ruiz-Avalos, J., Martínez-Jiménez, E., De Sarachaga, A. J., López-Hernández, J. C., León-Manriquez, E., & Vargas-Cañas, E. S. (2022). Autonomic dysfunction in patients with Guillain-Barre syndrome and related prognosis: From the clinic to the electrophysiology. (P8-13.003). Neurology, 98(18_supplement).

https://doi.org/10.1212/wnl.98.18_supplement.2511

10. Anandan, C., Khuder, S. A., & Koffman, B. M. (2017). Prevalence of autonomic dysfunction in hospitalized patients with Guillain-Barre syndrome. Muscle & Nerve, 56(2), 331-333.

https://doi.org/10.1002/mus.25551

11. Pagaling, G. T., Dichoso, L. P., Reyes, N. G., & Prado, M. B. (2025). Association of dysautonomia and different risk factors in patients with Guillain-Barre syndrome in a tertiary hospital in the Philippines. BMC Neurology, 25(1).

https://doi.org/10.1186/s12883-025-04029-3

12. Madden, J., Spadaro, A., Koyfman, A., & Long, B. (2024). High risk and low prevalence diseases: Guillain-Barre syndrome. The American Journal of Emergency Medicine, 75, 90-97.

https://doi.org/10.1016/j.ajem.2023.10.036

13. Zaeem, Z., Siddiqi, Z. A., & Zochodne, D. W. (2018). Autonomic involvement in Guillain–Barre syndrome: An update. Clinical Autonomic Research, 29(3), 289-299.

https://doi.org/10.1007/s10286-018-0542-y

14. Chakraborty, T., Kramer, C. L., Wijdicks, E. F., & Rabinstein, A. A. (2019). Dysautonomia in Guillain–Barre syndrome: Prevalence, clinical spectrum, and outcomes. Neurocritical Care, 32(1), 113-120.

https://doi.org/10.1007/s12028-019-00781-w

15. Arsenijevic, M., Berisavac, I., Bozovic, I., Stojiljkovic-Tamas, O., Palibrk, A., Lukic-Rajic, S., Vujovic, B., & Peric, S. (2021). Self-reported autonomic dysfunction in a recovery phase of Guillain-Barre syndrome. Clinical Neurology and Neurosurgery, 201, 106427.

https://doi.org/10.1016/j.clineuro.2020.106427

16. Keir, D. A., Badrov, M. B., Tomlinson, G., Notarius, C. F., Kimmerly, D. S., Millar, P. J., Shoemaker, J. K., & Floras, J. S. (2020). Influence of sex and age on muscle sympathetic nerve activity of healthy Normotensive adults. Hypertension, 76(3), 997-1005.

https://doi.org/10.1161/hypertensionaha.120.15208

17. Jiang, Y., Yabluchanskiy, A., Deng, J., Amil, F. A., Po, S. S., & Dasari, T. W. (2022). The role of age-associated autonomic dysfunction in inflammation and endothelial dysfunction. GeroScience, 44(6), 2655-2670.

https://doi.org/10.1007/s11357-022-00616-1

18. Papri, N., Islam, Z., Leonhard, S. E., Mohammad, Q. D., Endtz, H. P., & Jacobs, B. C. (2021). Guillain–Barre syndrome in low-income and middle-income countries: Challenges and prospects. Nature Reviews Neurology, 17(5), 285-296.

https://doi.org/10.1038/s41582-021-00467-y

19. Zaki, H. A., Iftikhar, H., Najam, M., Masood, M., Al-Marri, N. D., Elgassim, M. A., Fayed, M., & Shaban, E. E. (2023). Plasma exchange (PE) versus intravenous immunoglobulin (IVIG) for the treatment of Guillain-Barre syndrome (GBS) in patients with severe symptoms: A systematic review and meta-analysis. eNeurologicalSci, 31, 100468.

https://doi.org/10.1016/j.ensci.2023.100468

20. Kondziella, D. (2019). Autonomic dysfunction in Guillain–Barre syndrome puts patients at risk. Neurocritical Care, 32(1), 86-87.

https://doi.org/10.1007/s12028-019-00793-6

21. Fırat, Y. E., Akıncı, Z. K., Belen, B. G., Türkok, C. G., Sahin, S., & Karsidag, S. (2024). Prevalence and prognostic impact of hyponatremia in Guillain-Barre syndrome: A systematic review and meta-analysis. Cureus.

https://doi.org/10.7759/cureus.67215

22. Tatlı, G. A., Sarıkaya, E., & Yıldız, Ö. K. (2025). Guillain-Barre syndrome: A single-center experience. Turkish Journal of Neurology, 31(1), 001-008.

https://www.tjn.org.tr/abstract/2137/eng

23. Uncini, A., Ippoliti, L., Shahrizaila, N., Sekiguchi, Y., & Kuwabara, S. (2017). Optimizing the electrodiagnostic accuracy in Guillain-Barre syndrome subtypes: Criteria sets and sparse linear discriminant analysis. Clinical Neurophysiology, 128(7), 1176-1183.

https://doi.org/10.1016/j.clinph.2017.03.048

24. Çetiner, M., Seyit, M., Akdağ, G., Demirbaş, H., Temel, Ö., & Canbaz Kabay, S. (2019). Factors associated with prognosis in patients with Guillain-Barre syndrome. Turkish Journal Of Neurology, 25(3), 140-145.

https://doi.org/10.4274/tnd.2019.34445

25. Gong, Q., Liu, S., Xiao, Z., Fu, X., & Lu, Z. (2021). Elevated blood and cerebrospinal fluid glucose levels affect the severity and short-term prognosis of Guillain-Barre syndrome. Neurological Research, 44(2), 121-127.

https://doi.org/10.1080/01616412.2021.1965337

Downloads

Published

2025-07-15

How to Cite

Khalid, S., & Aslam, A. (2025). Frequency of Autonomic Dysfunction in Patients with Guillain Barre Syndrome. Indus Journal of Bioscience Research, 3(7), 775-779. https://doi.org/10.70749/ijbr.v3i7.2082