Prognosis of Guillain-Barré Syndrome in Children

Abstract

How to Cite This Article: Salehiomran MR, Nikkhah A, Mahdavi M. Prognosis of Guillain-Barré syndrome in Children. Iran J Child Neurol. Spring 2016; 10(2):38-41.AbstractObjectiveGuillain-Barre Syndrome (GBS) is an acute polyradiculoneuropathy characterized by progressive motor weakness of limbs and areflexia. In this study, our aim was to evaluate the clinical pattern and prognosis of children with Guillain-Barre syndrome.Materials & MethodsThis cross-sectional study was conducted in the Pediatric Neurology Unit of Amirkola Children’s Hospital, Babol, Iran during the period of 5 years from October 2008 to September 2013. We assessed the clinical features, results of electrodiagnostic tests, functional status, treatment and outcome of 17 children diagnosed with GBS.ResultsOf 17 (male to female ratio = 1.6:1) children studied, all had motor weakness, 4 children (23.5 %) and cranial nerve palsies. Respiratory paralysis was found in one child requiring assisted ventilation. Antecedent illness preceding GBS was recorded in 7 (41.2%) children. The GBS subtype distribution as per electrodiagnostic studies was as follows: acute inflammatory demyelinating  polyradiculoneuropathy (AIDP) in 12 (70.6%) acute motor axonal neuropathy (AMAN) in 3 (17.6%), acute motor sensory axonal neuropathy (AMSAN) in 2 (11.8%). IVIG constituted the treatment given in all of the patients. Complete recovery was observed in 16 children and the remaining one child was dependent to wheelchair.ConclusionGBS in children is not poor prognostic disorder and our recommendation is administration of IVIG as soon as possible after clinical diagnosis. Except for one child who remained wheelchair bound, there was no mortality or morbidity in long-term observation. Besides, strong limitation of our study was the low number of subjects. References1. Van Doorn PA, Ruts L, Jacobs BC, et al. Guillain-Barre Syndrome: Clinical features, Pathogenesis. Lancet Neurol 2008 Oct; 7(10):939 -50.2. Dhadke SV, Dhadke VN, Bangar SS, Korade MB. Clinical Profile of Guillain Barre Syndrome. J Asso Physicians India 2013; 61: 168-72.3. Pi-Lien H, Chang W, Huang L et al. A clinical and electrophysiologic survey of childhood Guillain-Barre syndrome. Pediatr Neurol 2004; 30(2): 86-91.4. Koul R, Al-Futaisi A, Chacko A et al. Clinical Characteristics of Childhood Guillain-Barré Syndrome. Oman Med J 2008; 23(3): 158–61.5. Asbury AK, Cornblath DR. Assessment of current diagnostic criteria for Guillain-Barre syndrome. Ann Neurol 1990; 27(suppl): S21-S24.6. Akbayram S, Doan M, Akgün C, Peker E, Sayın R, Aktar F, et al. Clinical features and prognosis with Guillain- Barré syndrome. Ann Indian Acad Neurol 2011; 14: 98-102.7. Loeffel VB, Rossi LN, Mumenyhaler M. The Landry Guillain-Barré syndrome complication prognosis and natural history of 123 cases. J Neural SG 1977; 33: 71-79.8. Maneesh Kumar, Shrikiran Aroor, Suneel Mundkur, Sandeep Kumar. Guillain-Barré Syndrome: A Clinical Study of Twenty Children. J Clin Diagc Res 2015 Jan; 9(1): 9-12.9. Korinthenberg R, Schulte Monting J. Natural history and treatment effects in Guillain-Barre syndrome: a multicentre study. Arch Dis Child 1996; 74: 281–87

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