Characteristics and Outcomes of Guillain-Barré Syndrome in Children.

BACKGROUND

Guillain-Barré syndrome (GBS) is one of the leading causes of acute paralysis in children. Our aim was to describe the clinical characteristics, paraclinical features, and recovery outcomes of children with GBS.

METHODS

This is a prospective study of 40 children diagnosed with GBS from January 2021 to December 2022. Data on demographics, clinical features, treatments, complications, and outcomes were collected at follow-up time points based on the Guillain-Barré disability score (GDS).

RESULTS

In the study of 40 children, the number of male children with GBS was predominant (82.5%), and more than 50% of GBS patients were older than 10 years. Seventy-five percent of patients with GBS had a preceding infection, with respiratory tract infections being the most common. The most common initial symptom was leg pain. Bulbar palsy was observed in 47.5% of patients and was a relatively frequent clinical feature in our cohort. Albuminocytological dissociation (ACD) rate within the first 7 days was 73.3%. Based on nerve conduction study results, the phenotypes were distributed as follows: acute inflammatory demyelinating polyneuropathy (AIDP) accounted for 55%; acute motor-sensory axonal neuropathy (AMSAN) for 17.5%; acute motor axonal neuropathy (AMAN) for 10%; inexcitable nerves for 5%; and unclassifiable cases for 12.5%. At the 6-month follow-up, 100% of pediatric patients achieved independent ambulation. Furthermore, a correlation was found between mechanical ventilation and GDS at 1 and 2 months; however, no association was observed at 3 and 6 months' postonset.

CONCLUSION

In pediatric GBS, the most common initial manifestations are limb pain and paresthesia. Most patients achieve good recovery; the need for mechanical ventilation is associated with bulbar weakness, facial paralysis, pneumonia, and severe initial limb weakness.