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Guillain–Barré Syndrome and Swallowing Dysfunction

Mengi, Tuğçe*; Seçil, Yaprak*; İncesu, Tülay Kurt*; Arici, Şehnaz*; Akkiraz, Zehra Özde*; Gürgör, Nevin*; Gedizlioğlu, Muhteşem; Ertekin, Cumhur

Journal of Clinical Neurophysiology: September 2017 - Volume 34 - Issue 5 - p 393–399
doi: 10.1097/WNP.0000000000000380
Original Research

Purpose: Patients with Guillain–Barré syndrome (GBS), especially severe cases that require treatment in intensive care units, often experience swallowing difficulties. However, the oropharyngeal function of patients with GBS not treated in intensive care units is not typically evaluated using neurophysiological techniques.

Methods: Electrophysiological techniques were used to determine dysphagia limit and sequential water swallowing values in an electromyography laboratory.

Results: This study assessed 18 patients with GBS who were not treated in the intensive care unit between 4 and 45 days after their hospital admission; 18 healthy volunteers were used as a control group. Of the 18 patients with GBS, 7 exhibited the clinical involvement of either a single cranial nerve or a combination of cranial nerves while 11 did not show any lower cranial nerve involvement. Clinical dysphagia was observed in seven patients and six of these cases involved a lower cranial nerve while five patients without cranial nerve involvement had silent dysphagia according to the dysphagia limit test. In addition, the duration of sequential swallowing was significantly prolonged in all patients with GBS compared with the control subjects.

Conclusions: The present findings demonstrated that neurophysiological techniques are useful and easily applicable for patients with GBS and that there were no complications. Furthermore, cranial nerve involvement in patients with GBS likely increased the incidence of oropharyngeal dysphagia, and subclinical dysphagia may be present in this population as well. Therefore, neurophysiological techniques can be initially used and then repeated during follow-up visits for all types of patients with GBS.

*Department of Clinical Neurophysiology, Katip Çelebi University Atatürk Training and Research Hospital, Karabağlar, İzmir, Turkey;

Department of Neurology, İzmir Training and Research Hospital, Karabağlar, İzmir, Turkey; and

Department of Clinical Neurophysiology and Neurology, Medical School Hospital, Aegean University, Bornova, İzmir, Turkey.

Address correspondence and reprint requests to Tuğçe Mengi, MD, Neurological Intensive Care Unit, Dokuz Eylül University Hospital, İzmir 35340, Turkey; e-mail: tugceangin@gmail.com.

The authors have no funding or conflicts of interest to disclose.

© 2017 by the American Clinical Neurophysiology Society