Pediatric Guillain-Barre syndrome: Indicators for a severe course


Varkal M. A., Uzunhan T. A., Aydinli N., Ekici B., Caliskan M., Ozmen M.

ANNALS OF INDIAN ACADEMY OF NEUROLOGY, vol.18, no.1, pp.24-28, 2015 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 18 Issue: 1
  • Publication Date: 2015
  • Doi Number: 10.4103/0972-2327.144274
  • Journal Name: ANNALS OF INDIAN ACADEMY OF NEUROLOGY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.24-28
  • Keywords: Guillain-Barre syndrome, intravenous immunoglobulin, mechanical ventilation, plasmapheresis, CLINICAL PRESENTATION, RANDOMIZED-TRIAL, PLASMA-EXCHANGE, CHILDHOOD, CHILDREN, PROGNOSIS, FEATURES
  • Istanbul University Affiliated: Yes

Abstract

Objectives: This study aims to retrospectively evaluate pediatric Guillain-Barre syndrome cases in a tertiary center in Istanbul, Turkey. Materials and Methods: The data of 40 patients with Guillain-Barre syndrome who had been admitted to the Department of Pediatrics at the Istanbul University Medical Faculty between 2005 and 2011 were collected. Mann-Whitney U, Kruskal-Wallis, chi-square, and Fisher's exact tests were used for statistical analysis. Results: Mean patient age was 5.4 +/- 3.0 years; 20 out of 40 patients (50%) were female and 20 (50%) were male. Preceding infection was detected in 32 cases (80%). Six patients had speech impairment. Out of eight patients with respiratory distress (20%), five required respiratory support (12.5%) of which three of them had speech impairment as well. According to nerve conduction studies, 21 patients (52.5%) had acute inflammatory demyelinating polyradiculoneuropathy, 14 (35%) had acute motor axonal neuropathy, and five (12.5%) had acute motor-sensory axonal neuropathy. Thirty-three patients (82.5%) received intravenous immunglobulin, 3 (7.5%) underwent plasmapheresis and 4 (10%) received both. Time until recovery (P = 0.022) and time until aided (P = 0.036) and unaided (P = 0.027) walking were longer in patients with acute gastrointestinal infection than in those with upper respiratory tract infection (P < 0.05). Time until response to treatment (P = 0.001), time until aided (P = 0.001) and unaided (P = 0.002) walking, and time until complete recovery (P = 0.002) were longer in acute motor axonal neuropathy cases as compared to acute inflammatory demyelinating polyradiculoneuropathy cases. Conclusion: Recovery was longer with acute gastrointestinal infection and acute motor axonal neuropathy. Speech impairment could be a clinical clue for the need of mechanical ventilation.