Rescue treatment in patients with poorly responsive Guillain–Barre syndrome

Abstract

Objectives: To evaluate the effectiveness of rescue treatment (intravenous immunoglobulin or plasma exchange) in patients with Guillain–Barre syndrome who did not respond or deteriorated after the initial management with intravenous immunoglobulin. Methods: We performed a retrospective review of the medical records of patients who responded poorly or did not respond to intravenous immunoglobulin treatment. The disability parameters of those who received second-line treatment with intravenous immunoglobulin or plasma exchange (20 patients) were compared with those who did not receive second-line treatment (19 patients). Results: There was a statistically significant improvement in disability scores at 1 month in the patients who received the rescue treatment (p = 0.033). However, there was no significant difference in the disability scores at 3 and 6 months, or in length of intensive care unit stay. Conclusion: Our study showed that a second course of treatment to carefully selected patients may be beneficial.