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  • 1. Forsberg, Anette
    et al.
    Press, Rayomand
    Karolinska Institutet, Karolinska University Hospital at Huddinge, Stockholm, Sweden.
    Einarsson, Ulrika
    Karolinska Institutet, Karolinska University Hospital at Huddinge, Stockholm, Sweden.
    de Pedro-Cuesta, Jesus
    Karolinska Institutet, Karolinska University Hospital at Huddinge, Stockholm, Sweden; National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain.
    Widén Holmqvist, Lotta
    Karolinska Institutet, Karolinska University Hospital at Huddinge, Stockholm, Sweden.
    Network Members of the Swedish Epidemiological Study Group,
    Impairment in Guillain-Barré syndrome during the first 2 years after onset: A prospective study2004In: Journal of the Neurological Sciences, ISSN 0022-510X, E-ISSN 1878-5883, Vol. 227, no 1, p. 131-138Article in journal (Refereed)
    Abstract [en]

    Objectives

    To provide a comprehensive description of impairment in patients with Guillain–Barré syndrome (GBS) in Sweden during the first 2 years after disease onset.

    Methods

    In this prospective multi-centre study, 42 patients, mean age 52 years, were evaluated at 2 weeks, 2 months, 6 months, 1 year and 2 years. Evaluations made use of validated, reliable measures of muscle strength, grip strength, finger dexterity, balance, facial-muscle function, respiratory function, gait, motor performance and sensory examination, and included patients' owns assessments of pain, fatigue and paraesthesia.

    Results

    Mechanical ventilation was required in 21% of patients. At 2 weeks, 1 year and 2 years after GBS onset: 100%, 62% and 55% of patients had submaximal overall muscle strength; 98%, 38% and 31% subnormal grip strength; and 38%, 14% and 12% affected facial-muscle function. At the same time points, 62%, 10% and 7% of patients were unable to walk 10 m independently; and affected sensation was detected in 93%, 55% and 52%.

    Conclusions

    Recovery occurred mainly during the first year after onset. At 2 years, motor impairment and sensory impairment were each still detectable in more than 50% of patients. We conclude that residual impairment is significant, somatically widespread and, likely, persistent.

  • 2.
    Forsberg, Anette
    et al.
    Division of neurology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Family Medicine Research Centre, Örebro county council, Örebro, Sweden.
    Press, Rayomand
    Division of neurology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Neurology, Karolinska University Hospital, Stockholm, Sweden.
    Widén Holmqvist, Lotta
    Division of neurology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Division of physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Residual disability 10 years after falling ill in Guillain-Barré syndrome: a prospective follow-up study2012In: Journal of the Neurological Sciences, ISSN 0022-510X, E-ISSN 1878-5883, Vol. 317, no 1-2, p. 74-79Article in journal (Refereed)
    Abstract [en]

    Objective: To describe residual disability 10years after onset of Guillain-Barré syndrome (GBS) and longitudinal changes from 2weeks after onset until 10years afterwards. The Erasmus GBS Outcome score (EGOS) was applied for predicting prognosis at 2 and 10years.

    Methods: Twenty-nine patients, mean age at onset 49years, were followed prospectively from 2weeks to 10years after GBS onset. Measures included; GBS disability score, EGOS, Barthel Index, Frenchay Activity Index, Sickness Impact Profile (SIP), Overall Neuropathy Limitations Scale (ONLS), Walk-12, and Fatigue Severity Scale.

    Results: At 10years, the facial paralysis found in 5 participants at 2years was still present, 11 participants (38%) experienced paresthesia, 6 (21%) had limitations in their arms, and 15 (52%) had limitations in walking. Decreased health-related quality of life on comparison to the general population was seen in the physical dimension of SIP at 10years. The median EGOS at 2weeks was 4.5, which correlated highly only with the Barthel Index at 2years and the ONLS arm scale at 10years.

    Conclusion: The residual disabilities at 1-2years comprised mainly of reduced walking ability, and are still persistent 10years after GBS onset. For some individuals, facial paralysis caused major disability. The EGOS only partly predicted residual disability at 2 and 10years after onset.

  • 3. Pontén, Eva
    et al.
    Lindström, Mona
    Kadi, Fawzi
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Higher amount of MyHC IIX in a wrist flexor in tetraplegic compared to hemiplegic cerebral palsy2008In: Journal of the Neurological Sciences, ISSN 0022-510X, E-ISSN 1878-5883, Vol. 266, no 1-2, p. 51-56Article in journal (Other academic)
    Abstract [en]

    Spastic cerebral palsy can be divided into diagnostic groups by the relative severity of the arm impairment. This study investigates if hemiplegic, tetraplegic or diplegic cerebral palsy (CP) results in different patterns of myosin heavy chain (MyHC) expression in the flexor carpi ulnaris muscle from 17 young patients with CP. Using enzyme-immunohistochemistry and gel electrophoresis techniques we found a higher percentage of fibers expressing fast MyHC IIx (52%) in tetraplegic CP compared to hemiplegic patients (32%), (p < 0.05). Tetraplegic CP also resulted in a lower amount of fibers expressing slow MyHC I (18%) compared to hemiplegic CP (40%), (p < 0.005). The proportion of muscle fibers containing fetal MyHC was higher in tetraplegic CP compared to other groups, (p < 0.005). Taken together theses results indicate that tetraplegic CP is associated with a shift from slow to fast myosins and that regenerative events are more prominent in tetraplegic CP compared with milder brain damage.

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