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Published on: November 9, 2017
Guillain-Barré syndrome in children
1Department of Neurology, Emory University School of Medicine, Atlanta, GA 30322, USA. jsladky@emory.edu
Insights
Guillain-Barré syndrome is a leading cause of paralysis in children, with most recovering fully. Early treatments like plasmapheresis and immunoglobulin may reduce illness severity.
Area of Science:
- Neurology
- Pediatrics
- Immunology
Background:
- Guillain-Barré syndrome (GBS) is the most frequent cause of acute paralysis in children in industrialized nations.
- Incidence in children (<18 years) is estimated at 0.5–1.5 per 100,000.
- About 15% of affected children experience respiratory failure requiring mechanical ventilation.
Discussion:
- Limited randomized trials exist for childhood GBS treatment.
- Case series suggest plasmapheresis and human immunoglobulin may decrease disease severity.
- Animal models, like experimental allergic neuritis, aid in understanding GBS pathogenesis.
Key Insights:
- Childhood Guillain-Barré syndrome often results in excellent prognoses, with most achieving full recovery within six months.
- Investigational treatments show promise in mitigating morbidity.
- Further research is needed to establish optimal therapeutic strategies.
Outlook:
- Future research should focus on prospective randomized trials for childhood GBS.
- Exploring novel therapeutic targets identified through animal models is crucial.
- Improving treatment protocols can enhance recovery outcomes and reduce long-term complications.
Abstract:
In industrialized nations with widespread immunization programs, Guillain-Barré syndrome is the most common cause of acute paralytic illness in children and adults. The incidence of the disease has been estimated to range from 0.5 to 1.5 in 100,000 in individuals less than 18 years of age. Approximately 15% of children with Guillain-Barré syndrome develop respiratory failure and require mechanical ventilatory support. Prospective randomized treatment trials in childhood Guillain-Barré syndrome are wanting; however, smaller case series studies using historical controls suggest that both plasmapheresis and administration of human immunoglobulin could be helpful in reducing morbidity in children with Guillain-Barré syndrome. The prognosis for recovery in children is generally excellent, with the majority of children achieving a complete functional recovery within 6 months from the onset of illness. Studies using an animal model of human Guillain-Barré syndrome, experimental allergic neuritis, have expanded our understanding of the pathogenesis of the disease and suggest new directions for exploration in the treatment of this disorder.
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