Risk factors for Guillain-Barré syndrome: a population-based case-control study

We performed the first population-based case-control study on clinical risk factors and drug exposure in Guillain-Barre syndrome (GBS). Sixty patients with GBS were collected through an incidence survey performed in the Emilia-Romagna region of northern Italy. GBS patients were compared with 109 hospital controls (HC) and 59 population controls (PC) as for clinical events and drug exposure during the month preceding the study inclusion. Comparison of HC with PC showed no significant difference in the frequency of clinical events which occurred during the preceding month. This indicated that our HC were well representative of the general population for the risk factors investigated. GBS patients were compared with HC or both HC and PC using both univariate and multivariate analysis. Univariate analysis showed a significant association with fever and upper airway infection symptoms occurring in the preceding month. Furthermore, a significantly higher exposure to antibiotics, antipyretics/analgesics, and gangliosides was observed. However, multivariate analysis showed that only fever was significantly related to GBS onset (OR 28, 95% CI 5.2–313 for GBS vs. HC; OR 29, 95% CI 7.0–256 for GBS vs. HC and PC).