Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Feb;32(1):113-120.
doi: 10.1007/s12028-019-00781-w.

Dysautonomia in Guillain-Barré Syndrome: Prevalence, Clinical Spectrum, and Outcomes

Tia Chakraborty  1 , Christopher L Kramer  2 , Eelco F M Wijdicks  3 , Alejandro A Rabinstein  3
Affiliations

Dysautonomia in Guillain-Barré Syndrome: Prevalence, Clinical Spectrum, and Outcomes

Tia Chakraborty et al. Neurocrit Care. 2020 Feb.

Abstract

Background: Guillain-Barré syndrome (GBS), when severe, involves the autonomic nervous system; our objective was to assess the spectrum and predictors of dysautonomia, and how it may impact functional outcomes.

Methods: A retrospective review of patients admitted to the Mayo Clinic in Rochester, MN between January 1, 2000, and December 31, 2017, with GBS and dysautonomia was performed. Demographics, comorbidities, parameters of dysautonomia, clinical course, GBS disability score, and Erasmus GBS Outcome Score (EGOS) at discharge were recorded.

Results: One hundred eighty seven patients were included with 71 (38%) noted to have at least one manifestation of dysautonomia. There are 72% of patients with a demyelinating form of GBS and 36% of patients with demyelination had dysautonomia. Ileus (42%), hypertension (39%), hypotension (37%), fever (29%), tachycardia or bradycardia (27%), and urinary retention (24%) were the most common features. Quadriparesis, bulbar and neck flexor weakness, and mechanical ventilation were associated with autonomic dysfunction. Patients with dysautonomia more commonly had cardiogenic complications, syndrome of inappropriate antidiuretic hormone, posterior reversible encephalopathy syndrome, and higher GBS disability score and EGOS. Mortality was 6% in patients with dysautonomia versus 2% in the entire cohort (P = 0.02).

Conclusions: Dysautonomia in GBS is a manifestation of more severe involvement of the peripheral nervous system. Accordingly, mortality and functional outcomes are worse. There is a need to investigate if more aggressive treatment is warranted in this category of GBS.

Keywords: Acute inflammatory demyelinating polyradiculoneuropathy; Autonomic dysfunction; Dysautonomia; Guillain–Barré syndrome.

PubMed Disclaimer

Comment in

References

    1. Wijdicks EF, Klein CJ. Guillain–Barre syndrome. Mayo Clin Proc. 2017;92(3):467–79. - PubMed - DOI
    1. Flachenecker P, Hartung HP, Reiners K. Power spectrum analysis of heart rate variability in Guillain–Barré syndrome. A longitudinal study. Brain. 1997;120(10):1885–94. - PubMed - DOI
    1. Tuck RR, McLeod JG. Autonomic dysfunction in Guillain–Barre syndrome. J Neurol Neurosurg Psychiatry. 1981;44(11):983–90. - PubMed - PMC - DOI
    1. Guz A, et al. The role of vagal and glossopharyngeal afferent nerves in respiratory sensation, control of breathing and arterial pressure regulation in conscious man. Clin Sci. 1966;30(1):161–70. - PubMed
    1. Pfeiffer G. Dysautonomia in Guillain–Barre syndrome. Nervenarzt. 1999;70(2):136–48. - PubMed - DOI

MeSH terms

Substances

LinkOut - more resources