Guillain-Barré syndrome in children: clinical course, electrodiagnosis, and prognosis

The electrodiagnostic features of acute childhood Guillain-Barré syndrome (GBS) have not been distinguished from those in the adult. We report nerve conduction and electromyographic data from 23 children. Sixty-one percent (14 of 23) fulfilled strict electrodiagnostic criteria for a demyelinating neuropathy, and the remainder demonstrated demyelination in at least one nerve. Reduced compound muscle action potential (CMAP) amplitude was the most common finding overall. Children less than 10 years old demonstrated significantly greater slowing of motor CV than children greater than 10 years old. Electrodiagnostic criteria associated with poor outcome (low mean CMAP and fibrillation potentials) in previous studies, primarily of adult patients, occurred in 39% (9 of 23 children). All patients on whom follow-up data were obtained recovered without residual disability. We conclude that electrodiagnostic prognostic indicators identified in general series of GBS may not apply to children.