Artículos de revistas
Guillain-barré Syndrome In The Elderly: Clinical, Electrophysiological, Therapeutic And Outcome Features
Arquivos De Neuro-psiquiatria. , v. 63, n. 3 B, p. 772 - 775, 2005.
Franca Jr. M.C.
De Castro R.
Marques Jr. J.F.C.
There are few papers devoted to geriatric Guillain-Barré (GBS) and many related issues remain unanswered. Objective: To describe clinical, electrophysiological and therapeutic features in this age. Method: Clinico-epidemiological data and therapy of GBS patients older than 60 years were reviewed. Hughes scores were used to quantify neurological deficit and define outcome. Results: Among 18 patients (mean age 64.8 years), 9 had evident prodrome and 80% noticed initially sensory-motor deficit. Demyelinating GBS was found in 8 and axonal in 6 subjects. There was one Miller-Fisher and 3 unclassified cases. Plasmapheresis (PFX) was single therapy in 12 patients and intravenous immunoglobulin (IVIg) in 2. Disability scores just before therapy were similar in both groups, so as short and long term outcome. Conclusion: Axonal GBS seems to be more frequent in the elderly and this may have prognostic implications. PFX and IVIg were suitable options, but complications were noticed with PFX. Prospective studies are needed to better understand and manage GBS in the elderly.633 B772775Kuwabara, S., Guillain-Barré syndrome: Epidemiology, pathophysiology and management (2004) Drugs, 64, pp. 597-610Hughes, R.A.C., Rees, J.H., Clinical and epidemiological features of Guillain-Barré syndrome (1997) J Infect Dis, 176 (SUPPL. 2), pp. S92-S98Hartung, H.P., Willison, H.J., Kieseier, B.C., Acute immunoinflammatory neuropathy: Update on Guillain-Barré syndrome (2002) Curr Opin Neurol, 15, pp. 571-577Efficiency of plasma exchange in Guillain-Barré syndrome: Role of replacement fluids (1987) Ann Neurol, 22, pp. 753-761Greenwood, R.J., Newsom Davis, J.M., Hughes, R.A.C., Controlled trial of plasma exchange in acute inflammatory polyradiculoneuropathy (1984) Lancet, 1, pp. 877-879Osterman, P.O., Lundemo, G., Pirskanen, R., Beneficial effects of plasma exchange in acute inflammatory polyradiculoneuropathy (1984) Lancet, 2, pp. 1296-1299Plasmapheresis and acute Guillain-Barré syndrome (1985) Neurology, 35, pp. 1096-1104Plasma exchange in Guillain-Barré syndrome: One-year follow-up (1992) Ann Neurol, 32, pp. 94-97Van Der Meché, F.G.A., Schmitz, P.I.M., A randomized trial comparing intravenous immune globulin and plasma exchange in Guillain-Barré syndrome (1992) N Engl J Med, 326, pp. 1123-1129Randomised trial of plasma exchange, intravenous immunoglobulin, and combined treatments in Guillain-Barré syndrome (1997) Lancet, 349, pp. 225-230Sridharan, G.V., Tallis, R.C., Gautam, P.C., Guillain-Barré syndrome in the elderly: A retrospective comparative study (1993) Gerontology, 39, pp. 170-175Winner, S.J., Evans, J.G., Guillain-Barré syndrome in Oxfordshire: Clinical features in relation to age (1993) Age Ageing, 22, pp. 164-170Yamashita, S., Morinaga, T., Matsumoto, K., Sakamoto, T., Kaku, N., Matsukura, S., Severe Guillain-Barré syndrome in aged patients: The effect of plasmapheresis (1992) Intern Med, 31, pp. 1313-1316Rana, S.S., Rana, S., Intravenous immunoglobulins versus plasmapheresis in older patients with Guillain-Barré syndrome (1999) J Am Geriatr Soc, 47, pp. 1387-1388Asbury, A.K., Cornblath, D.R., Assessment of current diagnostic criteria for Guillain-Barré syndrome (1990) Ann Neurol, 27 (SUPPL.), pp. S21-S24Seneviratne, U., Guillain-Barré syndrome (2000) Postgrad Med J, 76, pp. 774-782Hughes, R.A.C., Newsom-Davis, J.M., Perkin, G.D., Pierce, J.M., Controlled trial of prednisolone in acute polyneuropathy (1978) Lancet, 2, pp. 750-753Rocha, M.S.G., Brucki, S.M.D., Carvalho, A.A.S., Lima, U.W.P., Epidemiologic features of Guillain-Barre syndrome in São Paulo, Brazil (2004) Arq Neuropsiquiatr, 62, pp. 33-37Van Der Meche, F.G., Visser, L.H., Jacobs, B.C., Endtz, H.P., Meulstee, J., Van Doom, P.A., Guillain-Barré syndrome: Multifactorial mechanisms versus defined subgroups (1997) J Infect Dis, 176 (SUPPL. 2), pp. S99-S102Sheth, R.D., Riggs, J.E., Hobbs, G.R., Gutmann, L., Age and Guillain-Barré syndrome severity (1996) Muscle Nerve, 19, pp. 375-377Dias-Tosta, E., Kuckelhaus, C.S., Guillain-Barre syndrome in a population less than 15 years old in Brazil (2002) Arq Neuropsiquiatr, 60, pp. 367-373