1. Sensitivity of Brighton Criteria in diagnosing Guillain-Barre Syndrome in resource poor settings in Pakistan
Ali Ghazanfar, Haider Ghazanfar
1: Federal Medical and Dental College, Islamabad, Pakistan 2:Shifa College of Medicine, Islamabad, Pakistan
Introduction
Results
Conclusion
All the limbs were affected in 94% of the cases. The mean time to develop maximal weakness was found to be days.
The sensitivity for Brighton Criteria 1, 2 and 3 was found to be 68%, 86% and 89% respectively.
Guillain-Barre Syndrome (GBS) is an cell mediated autoimmune response against myelin
According to health experts, the disorder claimed more lives than dengue fever in the country in 2014.
GBS presents with multiple symptoms and signs making its diagnosis difficult
GBS results in ascending paralysis which can be fatal with days
Brighton criteria has been proposed to help out diagnosis GBS (1)
Brighton Criteria compromises of clinical symptoms and sub categories requiring specialized test (2) and is divided into 4 levels.
Brighton criteria is a useful tool in the diagnosis of Guillain-Barre Syndrome.
The Brighton criteria can help in short listing acute limb paralysis patient who need to be investigated for GBS
The use of Brighton criteria will help in earlier diagnosis and prompt treatment of the Guillain-Barre Syndrome patients
Aims & Objectives
Brighton criteria 4
Acute on set of bilateral and symmetric paralysis
And Decreased or absent tendon reflexes
And Monophasic illness pattern
Brighton criteria 3
Brighton criteria 1
Brighton criteria 2
Cerebrospinal fluid protein level above normal
Total white cell count in cerebrospinal fluid <50 cells/mm3 Or
Electrophysiological finding show GBS
Absence of alternative diagnosis
Acute flaccid paralysis
The objective of our study was to assess and validate the sensitivity of Brighton criteria in diagnosing GBS in Pakistani population.
Reference
Methods
Fokke C, van den Berg B, Drenthen J, Walgaard C, van Doorn PA, Jacobs BC. Diagnosis of Guillain-Barré syndrome and validation of Brighton criteria Brain Jan;137(Pt 1): doi: /brain/awt285. Epub 2013 Oct 26.
Goodfellow JA, Willison HJ. Guillain-Barré syndrome: a century of progress. Nat Rev Neurol Dec;12(12): doi: /nrneurol Epub 2016 Nov 18.
All diagnosed GBS patients were considered in the study
The GBS patients were assessed according to the parameters of the Brighton criteria
Patient with suspicion of another neuropathic disease were not included in the study
The data obtain was analyzed by SPSS version 22.