Clinical characteristics and outcomes of Guillain Barre syndrome: a hospital-based study at Benha university

Abstract

Abstract Background Guillain–Barré syndrome (GBS) is an acute immune-mediated polyradiculoneuropathy with heterogeneous presentation and prognosis. Early identification of predictors of poor outcome is essential to optimize management. This study evaluated clinical characteristics and determinants of 3-month functional outcomes in patients with GBS. Methods In this retrospective cohort study, 60 patients fulfilling NINDS and Brighton criteria for GBS were recruited (January 2024–October 2025). Clinical, laboratory, and electrophysiological data were analyzed. Functional outcomes at 3 months were assessed using the Hughes Disability Scale (HDS) and Overall Neuropathy Limitation Scale (ONLS). Results The mean age was 40.3 ± 17.8 years; 51.7% were males. Antecedent infection was documented in 90%, most commonly upper respiratory tract infection (46.7%) and gastrointestinal (GIT) infection (23.3%). Mechanical ventilation was required in 21.7%, and mortality was 5%. Demyelinating neuropathy was observed in 50%, axonal in 23.3%, and mixed patterns in 26.7%. Mean MRC sum score improved from 37.383 ± 4.662 at nadir to 48.433 ± 5.010 at discharge. Higher EGRIS scores strongly correlated with worse 3-month disability (ONLS: Rs = 0.669; HDS: Rs = 0.708; both p < 0.001). Independent predictors of poor outcome included GIT antecedent infection (OR ≈ 6.6), lower MRC at nadir (OR ≈ 0.68 per point), leukocytosis (OR ≈ 108.8), elevated CRP (OR ≈ 84.5), autonomic dysfunction (OR ≈ 37.5), bulbar involvement (OR ≈ 126.2), and axonal variants (OR ≈ 7.3; p ≤ 0.012). Conclusions Older age, axonal electrophysiological patterns, high EGRIS score, inflammatory markers, and severe motor or bulbar involvement independently predict poor short-term outcomes in GBS. Early risk stratification may improve targeted supportive care and prognostic counseling.