Electrophysiological Subtypes of Guillain-Barre Syndrome in the Bangladeshi Population: A Cross-Sectional Study

Abstract

Background: Guillain–Barré syndrome (GBS) exhibits significant regional differences in demographics, symptoms, electrophysiological subtypes, diagnostic features, and prognosis. Acute Inflammatory Demyelinating Polyradiculoneuropathy (AIDP) predominates in Western populations, the axonal variants—Acute Motor Axonal Neuropathy (AMAN) and Acute Motor and Sensory Axonal Neuropathy (AMSAN)—are more common in Asia. However, data on GBS subtypes in Bangladesh remain limited. This study aims to determine the distribution of GBS subtypes and their associated clinical and electrophysiological features. Methods: A cross-sectional study was conducted at Rajshahi Medical College Hospital from January 2016 to December 2017. A total of 45 clinically diagnosed GBS patients underwent nerve conduction studies (NCS) to classify subtypes. Clinical parameters were analyzed, including age, preceding infections, and motor function. Statistical associations between GBS subtypes and clinical findings were assessed using chi-square and t-tests. Results: Among the 45 patients, 55.6% were diagnosed with AMAN, 37.8% with AIDP, and 6.6% with AMSAN. AMAN was significantly more prevalent in younger patients, whereas AIDP was more common in older individuals. Preceding diarrheal illness was associated with AMAN and AMSAN (p = 0.026), while respiratory infections were linked to AIDP (p = 0.030). Axonal subtypes demonstrated lower CMAP amplitudes, while AIDP showed prolonged distal motor latency and reduced conduction velocity, indicating demyelination. Conclusions: AMAN is the predominant GBS subtype in Bangladesh, aligning with regional trends. Electrophysiological findings are crucial for early diagnosis and management of GBS. Further research is needed to investigate genetic and environmental factors influencing GBS subtypes in this population.