[Guillain-Barré syndrome in paediatrics. Different forms of presentation and difficulties involved in reaching an early diagnosis].

INTRODUCTION AND AIMS: An early diagnosis of Guillain-Barré syndrome can be difficult to achieve. We describe the presenting symptoms in patients with Guillain-Barré syndrome under the age of 15 years and analyse the initial clinical symptoms, their progression and the results of the complementary studies that were conducted.

PATIENTS AND

METHODS

We conducted a descriptive, retrospective study based on a review of the clinical records of patients admitted to the Paediatric Hospital at the Centro Hospitalario Pereira Rossell, Montevideo, Uruguay, between 1st January 2000 and 30th June 2006. The sample consisted of 50 patients with a mean age of 6 years and 3 months.

RESULTS

The presenting symptoms were pain (38%), paresis of the extremities (18%), cranial nerve compromise (6%), ataxia (2%) and associations of different types of symptoms (36%). Unusual presenting symptoms and/or atypical variants were observed in 19 patients (38%). Albumino-cytologic dissociation was observed in 23% of the spinal taps carried out in the first week of progression and in 92% of those carried out later on. As differential diagnoses, a total of 22 different diagnostic entities were recorded in 21 clinical records (42%) and 58 complementary studies were performed in order to rule them out.

CONCLUSIONS

In the early stages, the clinical manifestations can vary widely and the value of the initial complementary tests may be limited, which gives rise to important difficulties when it comes to establishing the initial orientation.