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Clinical characteristics of childhood guillain-barré syndrome
Insights
Guillain-Barré syndrome in Omani children under 15 shows low incidence and mortality. While serious, most children recover fully with treatments like intravenous immunoglobulins, which also shorten hospital stays.
Area of Science:
- Pediatric Neurology
- Infectious Diseases Epidemiology
Background:
- Guillain-Barré syndrome (GBS) is a rare autoimmune disorder affecting the peripheral nervous system.
- Pediatric GBS presents unique challenges in diagnosis and management.
Purpose of the Study:
- To determine the incidence, clinical presentation, and outcomes of GBS in children under 15 in Oman.
- To evaluate the effectiveness of treatments in this pediatric population.
Main Methods:
- A retrospective study of children under 15 with acute flaccid paralysis admitted to identify GBS.
- Diagnosis confirmed via clinical criteria, cerebrospinal fluid analysis, and nerve conduction studies.
- Treatment included intravenous immunoglobulins and plasmapheresis for select cases.
Main Results:
- Sixty-one children (20% of acute flaccid paralysis cases) were diagnosed with GBS.
- Annual incidence was 0.45 per 100,000 children under 15.
- Cranial nerve involvement occurred in 50.8%, and 18.3% required ventilation. Complete recovery averaged 69.1 days, with no mortality.
Conclusions:
- GBS is a significant pediatric neurological condition in Oman with a favorable prognosis.
- Prompt treatment with immunoglobulins can reduce recovery time and hospital stay.
- Long-term morbidity is low, emphasizing the importance of early diagnosis and management.
Objectives:
To find the incidence, clinical pattern and outcome of Guillain-Barre syndrome in the Sultanate of Oman in children less than 15 years of age.
Methods:
All children under fifteen years with acute flaccid paralysis were admitted to identify the underlying cause. The diagnosis of Gullain Barre syndrome was made by clinical criteria, cerebrospinal fluid findings and nerve conduction studies. Intravenous immunoglobulins were given to all and two needed plasmapharesis.
Results:
Sixty-one children were diagnosed as Guillan-Barré syndrome and constituted 20% of cases of acute flaccid paralysis. Males 39 (63.9%) outnumbered females (36.1%).The annual incidence below 15 years was 0.45/100,000. Cranial nerves were involved in 31 (50.8%) children. Albumino-cytological dissociation in cerebrospinal fluid was seen in 42/45(93.3%) cases. Acute relapse was seen in six (9.8%) cases. Eleven children (18.3%) needed ventilation. Complete recovery was seen in 45 to 310 days (mean 69.1 days). Three children (4.9%) were left with minimal residual deficit. There was no mortality.
Conclusions:
Guillain Barre syndrome is a serious disease, although recovery is the rule in children. The disease is associated with very low mortality and long term morbidity. Immunoglobulins have reduced the duration of hospital stay and the total time needed for recovery.
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