Anales de pediatria (Barcelona, Spain : 2003) · 2011
[Guillain-Barré syndrome: clinical presentation and prognosis in children under six years-old].
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Pérez-Lledó E, Díaz-Vico A, Gómez-Gosálvez F A
Аннотация
INTRODUCTION: Guillain-Barré syndrome (GBS) is an acute polyneuropathy that is difficult to diagnose in young children.
OBJECTIVES: To review the form of presentation of GBS in children under six years-old at the time of onset and the symptoms they had until the diagnosis, the findings in the complementary tests, and the progression and prognosis.
PATIENTS AND METHODS: All patients less than 6 years-old who fulfilled the Asbury et al criteria for the diagnosis of GBS were reviewed.
RESULTS: Eight patients with a mean age of 3.4 years were included. Of those 75% recorded a previous infection. The symptoms prior to the diagnosis were very heterogeneous which entailed a wide differential diagnosis with many complementary examinations. The mean time to diagnosis was 8.5 days. All of them (100%) had motor involvement in the lower limbs, 75% in the upper limbs and 12% in the respiratory muscles. Sensory and cranial nerve involvement was observed in 62.5% and 25%, respectively. Admission to intensive care was required for 25% of the patients. Albumino-cytological dissociation was observed in the CSF in 83.3% and all the electrophysiological tests were positive with different patterns. The prognosis was excellent in all patients.
CONCLUSIONS: GBS in children under 6 years-old is difficult to diagnosis due to the signs of onset often being unspecific. This entails a wide differential diagnosis, with the subsequent diagnostic delay. There is a good prognosis in all the electrophysiological sub-types in this age group.
OBJECTIVES: To review the form of presentation of GBS in children under six years-old at the time of onset and the symptoms they had until the diagnosis, the findings in the complementary tests, and the progression and prognosis.
PATIENTS AND METHODS: All patients less than 6 years-old who fulfilled the Asbury et al criteria for the diagnosis of GBS were reviewed.
RESULTS: Eight patients with a mean age of 3.4 years were included. Of those 75% recorded a previous infection. The symptoms prior to the diagnosis were very heterogeneous which entailed a wide differential diagnosis with many complementary examinations. The mean time to diagnosis was 8.5 days. All of them (100%) had motor involvement in the lower limbs, 75% in the upper limbs and 12% in the respiratory muscles. Sensory and cranial nerve involvement was observed in 62.5% and 25%, respectively. Admission to intensive care was required for 25% of the patients. Albumino-cytological dissociation was observed in the CSF in 83.3% and all the electrophysiological tests were positive with different patterns. The prognosis was excellent in all patients.
CONCLUSIONS: GBS in children under 6 years-old is difficult to diagnosis due to the signs of onset often being unspecific. This entails a wide differential diagnosis, with the subsequent diagnostic delay. There is a good prognosis in all the electrophysiological sub-types in this age group.