A síndrome de Guillain-Barré (SGB) é identificada em todo o hemisfério ocidental sem concentração geográfica, mas com pequenas variações sazonais.[10]Webb AJ, Brain SA, Wood R, et al. Seasonal variation in Guillain-Barré syndrome: a systematic review, meta-analysis and Oxfordshire cohort study. J Neurol Neurosurg Psychiatry. 2015 Nov;86(11):1196-201.
https://jnnp.bmj.com/content/86/11/1196.long
http://www.ncbi.nlm.nih.gov/pubmed/25540247?tool=bestpractice.com
Estudos de base populacional mostram taxas de incidência anual médias absolutas que variam de 0.6 a 1.9 a cada 100,000 pessoas. Poucos surtos têm sido relatados, incluindo o surto de 1976 nos EUA depois do programa de gripe (influenza) suína (embora a relação entre a imunização de influenza e a incidência de SGB não seja clara).[11]Leonhard SE, Mandarakas MR, Gondim FAA, et al. Diagnosis and management of Guillain-Barré syndrome in ten steps. Nat Rev Neurol. 2019 Nov;15(11):671-83.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6821638
http://www.ncbi.nlm.nih.gov/pubmed/31541214?tool=bestpractice.com
[5]Yuki N, Hartung HP. Guillain-Barré syndrome. N Engl J Med. 2012 Jun 14;366(24):2294-304.
http://www.ncbi.nlm.nih.gov/pubmed/22694000?tool=bestpractice.com
A SGB é ligeiramente mais comum em homens do que mulheres, com uma proporção estimada entre homens e mulheres de 1.78.[5]Yuki N, Hartung HP. Guillain-Barré syndrome. N Engl J Med. 2012 Jun 14;366(24):2294-304.
http://www.ncbi.nlm.nih.gov/pubmed/22694000?tool=bestpractice.com
[12]Willison HJ, Jacobs BC, van Doorn PA. Guillain-Barré syndrome. Lancet. 2016 Aug 13;388(10045):717-27.
https://www.doi.org/10.1016/S0140-6736(16)00339-1
http://www.ncbi.nlm.nih.gov/pubmed/26948435?tool=bestpractice.com
A polirradiculoneuropatia desmielinizante inflamatória aguda (PDIA) é a forma mais comum na América do Norte e Europa e é responsável por 85% a 90% dos casos.[13]Poropatich KO, Walker CL, Black RE. Quantifying the association between Campylobacter infection and Guillain-Barré syndrome: a systematic review. J Health Popul Nutr. 2010 Dec;28(6):545-52.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2995022
http://www.ncbi.nlm.nih.gov/pubmed/21261199?tool=bestpractice.com
[14]The French Cooperative Group on Plasma Exchange in Guillain-Barré Syndrome. Appropriate number of plasma exchanges in Guillain-Barré syndrome. Ann Neurol. 1997 Mar;41(3):298-306.
http://www.ncbi.nlm.nih.gov/pubmed/9066350?tool=bestpractice.com
A PDIA pode ocorrer em qualquer idade, embora raramente na primeira infância, e a incidência aumenta com a idade; a idade média de início é de aproximadamente 40 anos.[12]Willison HJ, Jacobs BC, van Doorn PA. Guillain-Barré syndrome. Lancet. 2016 Aug 13;388(10045):717-27.
https://www.doi.org/10.1016/S0140-6736(16)00339-1
http://www.ncbi.nlm.nih.gov/pubmed/26948435?tool=bestpractice.com
[15]Winer JB, Hughes RA, Anderson MJ, et al. A prospective study of acute idiopathic neuropathy. II. Antecedent events. J Neurol Neurosurg Psychiatry. 1988 May;51(5):613-8.
https://jnnp.bmj.com/content/jnnp/51/5/613.full.pdf
http://www.ncbi.nlm.nih.gov/pubmed/3404161?tool=bestpractice.com
A SGB é a causa mais comum de paralisia flácida aguda em crianças.[16]Jones HR Jr. Guillain-Barré syndrome in children. Curr Opin Pediatr. 1995 Dec;7(6):663-8.
http://www.ncbi.nlm.nih.gov/pubmed/8776016?tool=bestpractice.com
O subtipo neuropatia axonal motora aguda (NAMA) da SGB é mais comum no Japão e na China, particularmente em jovens. Ela ocorre com mais frequência durante o verão.[17]Ho TW, Mishu B, Li CY, et al. Guillain-Barré syndrome in northern China. Relationship to Campylobacter jejuni infection and anti-glycolipid antibodies. Brain. 1995 Jun;118 ( Pt 3):597-605.
http://www.ncbi.nlm.nih.gov/pubmed/7600081?tool=bestpractice.com
A NAMA esporádica afeta 10% a 20% dos pacientes com SGB no mundo todo.[18]Jacobs BC, van Doorn PA, Schmitz PI, et al. Campylobacter jejuni infections and anti-GM1 antibodies in GBS. Ann Neurol. 1996 Aug;40(2):181-7.
http://www.ncbi.nlm.nih.gov/pubmed/8773599?tool=bestpractice.com
A síndrome de Miller-Fisher afeta entre 5% e 10% dos pacientes com SGB nos países ocidentais, mas é mais comum no leste da Ásia, afetando 25% dos pacientes com SGB no Japão e 19% em Taiwan.[19]Lyu RK, Tang LM, Cheng SY, et al. Guillain-Barré syndrome in Taiwan: a clinical study of 167 patients. J Neurol Neurosurg Psychiatry. 1997 Oct;63(4):494-500.
https://jnnp.bmj.com/content/jnnp/63/4/494.full.pdf
http://www.ncbi.nlm.nih.gov/pubmed/9343130?tool=bestpractice.com
A SGB está associada a surtos do vírus da Zika. Uma metanálise estimou que 1.23% das pessoas com o vírus da Zika desenvolvem SGB, e outra estimou que a incidência de SGB na América Latina e no Caribe aumentou 2.6 vezes durante os surtos do vírus da Zika.[20]Barbi L, Coelho AVC, Alencar LCA, et al. Prevalence of Guillain-Barré syndrome among Zika virus infected cases: a systematic review and meta-analysis. Braz J Infect Dis. 2018 Mar-Apr;22(2):137-41.
https://www.sciencedirect.com/science/article/pii/S1413867017309340?via%3Dihub
http://www.ncbi.nlm.nih.gov/pubmed/29545017?tool=bestpractice.com
[21]Capasso A, Ompad DC, Vieira DL, et al. Incidence of Guillain-Barré Syndrome (GBS) in Latin America and the Caribbean before and during the 2015-2016 Zika virus epidemic: A systematic review and meta-analysis. PLoS Negl Trop Dis. 2019 Aug;13(8):e0007622.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6730933
http://www.ncbi.nlm.nih.gov/pubmed/31449532?tool=bestpractice.com
Um estudo nas Américas revelou que pouco menos da metade das 51 mortes associadas ao vírus da Zika estavam relacionadas à SGB.[22]Cardona-Ospina JA, Henao-SanMartin V, Acevedo-Mendoza WF, et al. Fatal Zika virus infection in the Americas: A systematic review. Int J Infect Dis. 2019 Nov;88:49-59.
https://www.doi.org/10.1016/j.ijid.2019.08.033
http://www.ncbi.nlm.nih.gov/pubmed/31499212?tool=bestpractice.com
Houve vários relatos de vários países de pacientes com infecção confirmada por doença do coronavírus 2019 (COVID-19) desenvolvendo SGB.[23]Uncini A, Vallat JM, Jacobs BC. Guillain-Barré syndrome in SARS-CoV-2 infection: an instant systematic review of the first six months of pandemic. J Neurol Neurosurg Psychiatry. 2020 Oct;91(10):1105-10.
https://www.doi.org/10.1136/jnnp-2020-324491
http://www.ncbi.nlm.nih.gov/pubmed/32855289?tool=bestpractice.com
[24]Caress JB, Castoro RJ, Simmons Z, et al. COVID-19-associated Guillain-Barré syndrome: The early pandemic experience. Muscle Nerve. 2020 Oct;62(4):485-91.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7405390
http://www.ncbi.nlm.nih.gov/pubmed/32678460?tool=bestpractice.com
[25]Hasan I, Saif-Ur-Rahman KM, Hayat S, et al. Guillain-Barré syndrome associated with SARS-CoV-2 infection: A systematic review and individual participant data meta-analysis. J Peripher Nerv Syst. 2020 Dec;25(4):335-43.
https://www.doi.org/10.1111/jns.12419
http://www.ncbi.nlm.nih.gov/pubmed/33112450?tool=bestpractice.com
A idade média relatada (55 a 59 anos) e a predominância do sexo masculino de pacientes que desenvolvem SGB parecem ser típicos de pacientes com COVID-19 hospitalizados.[23]Uncini A, Vallat JM, Jacobs BC. Guillain-Barré syndrome in SARS-CoV-2 infection: an instant systematic review of the first six months of pandemic. J Neurol Neurosurg Psychiatry. 2020 Oct;91(10):1105-10.
https://www.doi.org/10.1136/jnnp-2020-324491
http://www.ncbi.nlm.nih.gov/pubmed/32855289?tool=bestpractice.com
[24]Caress JB, Castoro RJ, Simmons Z, et al. COVID-19-associated Guillain-Barré syndrome: The early pandemic experience. Muscle Nerve. 2020 Oct;62(4):485-91.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7405390
http://www.ncbi.nlm.nih.gov/pubmed/32678460?tool=bestpractice.com
[25]Hasan I, Saif-Ur-Rahman KM, Hayat S, et al. Guillain-Barré syndrome associated with SARS-CoV-2 infection: A systematic review and individual participant data meta-analysis. J Peripher Nerv Syst. 2020 Dec;25(4):335-43.
https://www.doi.org/10.1111/jns.12419
http://www.ncbi.nlm.nih.gov/pubmed/33112450?tool=bestpractice.com
São necessárias mais evidências sobre se a incidência de SGB em pacientes com COVID-19 é maior do que na população em geral.[24]Caress JB, Castoro RJ, Simmons Z, et al. COVID-19-associated Guillain-Barré syndrome: The early pandemic experience. Muscle Nerve. 2020 Oct;62(4):485-91.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7405390
http://www.ncbi.nlm.nih.gov/pubmed/32678460?tool=bestpractice.com
Também houve relatos de SGB após a vacinação contra COVID-19.[26]European Medicines Agency. Meeting highlights from the Pharmacovigilance Risk Assessment Committee (PRAC) 3-6 May 2021. May 2021 [internet publication].
https://www.ema.europa.eu/en/news/meeting-highlights-pharmacovigilance-risk-assessment-committee-prac-3-6-may-2021