@article{99faf47fde9f417ab5715e576e6fe63f,
title = "Current treatment practice of Guillain-Barr{\'e} syndrome",
abstract = "Objective To define the current treatment practice of Guillain-Barr{\'e} syndrome (GBS).Methods The study was based on prospective observational data from the first 1,300 patients included in the International GBS Outcome Study. We described the treatment practice of GBS in general, and for (1) severe forms (unable to walk independently), (2) no recovery after initial treatment, (3) treatment-related fluctuations, (4) mild forms (able to walk independently), and (5) variant forms including Miller Fisher syndrome, taking patient characteristics and hospital type into account.Results We excluded 88 (7%) patients because of missing data, protocol violation, or alternative diagnosis. Patients from Bangladesh (n = 189, 15%) were described separately because 83% were not treated. IV immunoglobulin (IVIg), plasma exchange (PE), or other immunotherapy was provided in 941 (92%) of the remaining 1,023 patients, including patients with severe GBS (724/743, 97%), mild GBS (126/168, 75%), Miller Fisher syndrome (53/70, 76%), and other variants (33/40, 83%). Of 235 (32%) patients who did not improve after their initial treatment, 82 (35%) received a second immune modulatory treatment. A treatment-related fluctuation was observed in 53 (5%) of 1,023 patients, of whom 36 (68%) were re-treated with IVIg or PE.Conclusions In current practice, patients with mild and variant forms of GBS, or with treatment-related fluctuations and treatment failures, are frequently treated, even in absence of trial data to support this choice. The variability in treatment practice can be explained in part by the lack of evidence and guidelines for effective treatment in these situations.",
author = "Christine Verboon and Doets, {Alex Y.} and Giuliana Galassi and Amy Davidson and Waqar Waheed and Yann P{\'e}r{\'e}on and Nortina Shahrizaila and Susumu Kusunoki and Lehmann, {Helmar C.} and Thomas Harbo and Soledad Monges and {Van Den Bergh}, Peter and Willison, {Hugh J.} and Cornblath, {David R.} and Jacobs, {Bart C.} and Hughes, {R. A.C.} and Gorson, {K. C.} and Hartung, {H. P.} and {Van Doorn}, {P. A.} and {Van den Berg}, B. and J. Roodbol and {Van Woerkom}, M. and Reisin, {R. C.} and Reddel, {S. W.} and Z. Islam and B. Islam and Mohammad, {Q. D.} and Feasby, {T. E.} and E. Dardiotis and E. Nobile-Orazio and K. Bateman and I. Illa and L. Querol and Hsieh, {S. T.} and G. Chavada and Addington, {J. M.} and S. Ajroud-Driss and H. Andersen and G. Antonini and A. Ariatti and S. Attarian and Badrising, {U. A.} and Barroso, {F. A.} and L. Benedetti and A. Beronio and M. Bianco and D. Binda and C. Briani and C. Bunschoten and J. B{\"u}rmann and Bella, {I. R.} and Bertorini, {T. E.} and R. Bhavaraju-Sanka and Brannagan, {T. H.} and M. Busby and S. Butterworth and C. Casasnovas and G. Cavaletti and Chao, {C. C.} and S. Chen and S. Chetty and Claeys, {K. G.} and Conti, {M. E.} and Cosgrove, {J. S.} and MC Dalakas and C. Demichelis and Derejko, {M. A.} and U. Dillmann and Dimachkie, {M. M.} and K. Doppler and {Dornonville de la Cour}, C. and A. Echaniz-Laguna and F. Eftimov and Faber, {C. G.} and R. Fazio and C. Fokke and T. Fujioka and Fulgenzi, {E. A.} and T. Garcia-Sobrino and Garssen, {M. P.J.} and Georgios, {H. M.} and Gijsbers, {C. J.} and Gilchrist, {J. M.} and J. Gilhuis and E. Giorli and Goldstein, {J. M.} and Goyal, {N. A.} and V. Granit and A. Grapperon and G. Guti{\'e}rrez and Hadden, {R. D.M.} and Holbech, {J. V.} and Holt, {J. K.L.} and Pedret, {C. H.} and M. Htut and K. Jellema and Pascual, {I. J.} and Miller, {J. A.L.} and Rajabally, {Y. A.} and Roberts, {R. C.}",
note = "Publisher Copyright: {\textcopyright} American Academy of Neurology.",
year = "2019",
month = jul,
day = "2",
doi = "10.1212/WNL.0000000000007719",
language = "English",
volume = "93",
pages = "E59--E76",
journal = "Neurology ",
issn = "0028-3878",
number = "1",
}