Abstract

Background and Aim: Plasmapheresis or plasma exchange is the most effective and treatment of choice in many neurological disorders. Thus the objective was to study the efficacy of plasmapheresis, compared to other therapies in Guillain Barre Syndrome (GBS). Materials and Methods: A prospective interventional study done on 164 patients with acute neurological disorder i.e., Guillain Barre Syndrome (GBS) admitted in a tertiary hospital in South India. 22 patients were treated with IVIg, 46 with small volume plasma exchange (SmVPE) and 5 with large volume plasma exchange (LVPE). They were compared with 91 patients on supportive therapy. Outcome of treatment was assessed by Hughes disability score and mortality at the end of 2weeks, one month and 3 months. Data analysed in percentages, paired and unpaired t-test. Results: Out of 164 patients, 1.8% overall mortality was observed. Although early recovery (14days) was seen with IVIg compared to plasmapheresis (18 days), improve in muscle weakness was more by one grade early in SmVPE than IVIg. Statistically significant improvement was seen in three treatment modalities compared to control but equal efficacy observed in plasma exchange and IVIg. Conclusions: In a developing country like India where socio economic status is very low where many people who can’t afford costlier treatment like IVIG and PE, they can be treated with small volume plasma exchanges which are cheaper and with fewer complications.

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