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[Autonomic dysfunction in Guillain-Barré Syndrome: a 13 year experience in pediatric intensive care unit]
J C Santana1, P C Garcia, P R Einloft
1Pediatra Intensivista do Hospital São Lucas da PUCRS, Porto Alegre, RS, Brasil.
Insights
Guillain-Barré Syndrome (GBS) in children can be severe but often has a good prognosis. Autonomic dysfunction, particularly hypertension, frequently complicates GBS, impacting cardiovascular stability.
Area of Science:
- Neurology
- Immunology
- Pediatrics
Context:
- Guillain-Barré Syndrome (GBS) is an immune-mediated peripheral nervous system disorder.
- Children with GBS can present severely, necessitating intensive care.
- Autonomic dysfunction is a known complication of GBS.
Purpose:
- To retrospectively analyze the clinical presentation and complications of GBS in children.
- To investigate the frequency and impact of autonomic disorders, specifically hypertension, in pediatric GBS.
- To evaluate the outcomes of children with GBS admitted to a Pediatric Intensive Care Unit.
Summary:
- This retrospective study reviewed 21 children with GBS admitted to a Pediatric Intensive Care Unit over 13 years.
- Hypertension and other autonomic disturbances were frequently observed, especially in severe cases.
- Cardiovascular instability, including labile blood pressure and arrhythmias, resulted from autonomic nervous system involvement.
- Mechanical ventilation was required for eight patients.
- No deaths occurred in the study group, highlighting the effectiveness of modern pediatric intensive care.
Impact:
- Highlights the significant association between GBS and autonomic dysfunction in children.
- Emphasizes the importance of monitoring cardiovascular stability in pediatric GBS patients.
- Suggests that with appropriate intensive care, pediatric GBS has a favorable prognosis despite potential severity.
Abstract:
The acute inflammatory demyelinating polyneuropathy (Guillain-Barré Syndrome) might have a severe presentation but a good prognosis in children. It is an immune-mediated and inflammatory disorder of the peripheral nervous system. This retrospective study observed that GBS is frequently complicated by hypertension and other autonomic disorders. Cardiovascular instability is due to the involvement of the autonomic nervous system and results in labile blood pressure, cardiac dysrhythmias and hypovolemia. During a 13-year period (1982-1995), 21 children were admitted to the Pediatric Intensive Care Unit of São Lucas Hospital, Porto Alegre, south of Brazil. Eight patients were mechanically ventilated. Symptoms of autonomic disturbance were frequently seen, especially in patients with severe clinical evolution. Previous investigations of the mechanism of hypertension associated with GBS did not evaluate the etiology of these phenomena. With modern pediatric intensive care support the deaths are rare. There is no death in this studied group.
