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Characteristics of Guillain-Barré syndrome in super-elderly individuals

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Abstract

Background

Japan has the world’s largest super-aging population, and the number of elderly patients with various diseases is increasing. Herein, we reported the characteristics of super-elderly patients, aged over 80 years, with Guillain-Barré syndrome (GBS), a typical neuroimmune disease.

Methods

During the period 2019–2021, 74 patients over the age of 80 years diagnosed with GBS at Kindai university were analyzed as the super-elderly group patients. The control group comprised 74 consecutive patients aged < 79 years, under the same conditions. GBS was diagnosed using Brighton diagnostic criteria. Electrophysiology was assessed using the Ho criteria.

Results

The mean age was 83.5 years in the super-elderly group and 51.7 years in the control group. Prior infection was recognized in 50% of cases in the super-elderly group and 77% of cases in the control group with fewer cases in the super-elderly group. The mean number of days until peak symptom presentation was longer in the super-elderly group. The percentage who required a ventilator was significantly higher among the super-elderly group than among the control group. Hughes functional grading scale was more severe in the super-elderly group. Electrophysiological examination revealed the demyelinating form was particularly common in the super-elderly group. Intravenous immunoglobulin was the most common treatment in both the groups, with no difference in efficacy.

Conclusions

Super-elderly onset GBS tends to be severe, therefore it is important to diagnose and treat appropriately, even in the absence of prior episodes of infection.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

AIDP:

Acute inflammatory demyelinating polyneuropathy

AMAN:

Acute motor axonal neuropathy

CSF:

Cerebrospinal fluid

GBS:

Guillain-Barré syndrome

HFGS:

Hughes functional grading scale

MRC:

Medical Research Council

IVIg:

Intravenous immunoglobulin

IVMP:

Intravenous methylprednisolone

PE:

Plasma exchange

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Acknowledgements

This study was supported by the JSPS KAKENHI (20K07894).

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Authors and Affiliations

  1. Department of Neurology, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8509, Japan

    Mai Minamino, Katsuichi Miyamoto, **soo Koh & Hidefumi Ito

  2. Department of Neurology, Kindai University School of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan

    Katsuichi Miyamoto, Motoi Kuwahara, Keisuke Yoshikawa, Susumu Kusunoki & Yoshitaka Nagai

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  1. Mai Minamino
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  2. Katsuichi Miyamoto
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  3. Motoi Kuwahara
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  4. Keisuke Yoshikawa
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  5. **soo Koh
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  6. Susumu Kusunoki
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  7. Yoshitaka Nagai
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  8. Hidefumi Ito
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Contributions

Study concept and design: KM, SK, YN and HI; data acquisition: MM and KM; data analysis and interpretation: MM, JK, KY and MK. All the authors have read and approved the final version of the manuscript.

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Correspondence to Katsuichi Miyamoto.

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Minamino, M., Miyamoto, K., Kuwahara, M. et al. Characteristics of Guillain-Barré syndrome in super-elderly individuals. J Neurol 270, 2191–2196 (2023). https://doi.org/10.1007/s00415-023-11567-8

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