Incidence and outcome of Guillain-Barre syndrome in Iceland: A population-based study

ObjectiveIn this study, we determine the incidence and outcomes of Guillain-Barre syndrome (GBS) in Iceland over a 20-year period. MethodCases were identified from the records of both referral hospitals in the country. All cases met the Brighton Criteria for GBS. Disability was assessed at diagnosis, peak of symptoms, discharge, and follow-up using the Guillain-Barre Disability Scale. ResultsSixty-three individuals fulfilled the diagnostic criteria with an average age of onset of 46years (range 1-89years) and a male:female ratio of 1. The average annual incidence was 1.1 per 100000 person-years. Nerve conduction studies were consistent with demyelinating polyneuropathy in 87% of cases, acute motor axonal neuropathy (AMAN) in 4%, and were normal in 9%. Treatment was received by 89% of patients and included IVIG (84%), plasmapheresis (8%), or both treatments (3%). Mechanical ventilation was required by 22% of patients. Long-term follow-up with an average length of 6.5years was available for 98% of patients, and the average GBS disability score at follow-up was 0.9. Four deaths related to GBS (6%) were observed. ConclusionWe believe we have identified all patients diagnosed with GBS in Iceland during the study period, with an incidence comparable to recent studies from well-defined populations around the world. Our reported mortality is similar to or higher than other population-based studies. At follow-up, 13% of patients still required a walking aid, but most survivors (74%) had minor or no symptoms.