Electrophysiological features and prognosis of Guillain-Barré syndrome in Israel: A single-center's 20 years' experience

We previously reported on 40 patients with Guillain-Barré syndrome (GBS) identified 1999–2005 at our center, and showed that a higher proportion had an axonal pattern, compared to Europe and North America. Retrospective chart review of 100 adult patients with GBS between 2006 and 2018 at Shamir Medical Center. 46.8% of those with an abnormal EMG had an axonal pattern. Of the 60 patients who presented with mild disease (defined as Hughes score 1–2), walking deteriorated in 35 (58%, considering any worsening of Hughes score). 20 patients (33%) lost the ability to walk independently (Hughes score 3), 8 reached a point they could not walk (Hughes 4), and 2 needed mechanical ventilation. Ninety-four of 100 patients (94%) were treated with intravenous immunoglobulins (IVIg). Using ECG monitoring and DVT prophylaxis, IVIg-related adverse reactions were rare. This study demonstrated a higher proportion of axonal GBS patients in Israel, compared to European and North American patients, replicating the findings in the 1999–2005 patients. Due to the progressive nature of the disease, with more than half of patients presenting with mild disease deteriorating and needing inpatient rehabilitation - we advocate initiation of treatment once a clinical diagnosis of GBS is made. •20 years' experience with GBS in a single center in Israel•Consistently higher axonal pattern in Israel than in USA or Europe•Treatment of mild patients supported•Low frequency of adverse events with DVT prophylaxis and ECG monitoring