Tremor Following Guillain Barré Syndrome

Tremor Other Hyperkinet Mov (N Y). 2024 Oct 25:14:53. doi: 10.5334/tohm.906. eCollection 2024.

Abstract

Background: Neuropathic tremor occurs with damage to the peripheral nervous system. Guillain-Barré syndrome (GBS) causes acute paralysis following nerve inflammation sometimes resulting in long-term disability. It is unclear how frequent and severe tremor is following GBS.

Objectives: We aimed to assess the frequency and features of tremor following GBS.

Methods: We enrolled 18 patients with GBS treated in a secondary care center within a 4-year period. Evaluations were done with the Fahn-Tolosa-Marin tremor rating scale (FTM-TRS). We compared these features with a cohort of consecutive patients with untreated essential tremor (ET).

Results: There were 13 males and 5 females with a mean age at evaluation (S.D.) of 41.5 ± 14.0 years and at GBS onset of 40.2 ± 13.7. No patient had history of tremor before GBS. Upper limb tremor was identified in 16 (89%) cases, 35.5% of patients had FTM-TRS score ≥10 points. Tremor was mostly kinetic, jerky with low amplitude with a total score of 10.94 ± 11.84 in the FTM-TRS. Compared with patients with ET, those with GBS-tremor were younger and had lower scores in all subscales of the FTM-TRS (P value < 0.05 for all comparisons). In a multivariate linear regression analysis "days of hospitalization" had a positive association with the total FTM-TRS score (P = 0.001).

Conclusions: Tremor was common following GBS. This tremor is mild compared with patients with ET, but adds functional impact.

Keywords: Guillain-Barré; axonal; neuropathic; polyneuropathy; syndrome; tremor.

MeSH terms

  • Adult
  • Aged
  • Essential Tremor / complications
  • Essential Tremor / epidemiology
  • Essential Tremor / physiopathology
  • Female
  • Guillain-Barre Syndrome* / complications
  • Guillain-Barre Syndrome* / epidemiology
  • Guillain-Barre Syndrome* / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Severity of Illness Index
  • Tremor* / epidemiology
  • Tremor* / etiology
  • Tremor* / physiopathology