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[Acute polyradiculoneuritis in children: apropos of 71 cases]
M Trabelsi1, R Mokrani, B Bennaceur
1Service de pédiatrie, hôpital d'Enfants, Tunis, Jebbari, Tunisie.
Insights
Guillain-Barré syndrome in children often follows infection, causing sudden paralysis. While many children recover, some experience long-term deficits, with age and disease duration impacting prognosis.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Neuroimmunology
Context:
- Guillain-Barré syndrome (GBS) is a rare autoimmune disorder affecting the peripheral nervous system.
- Pediatric GBS presents unique diagnostic and management challenges.
- Understanding GBS epidemiology and clinical course in children is crucial for effective care.
Purpose:
- To analyze the clinical features, treatment outcomes, and prognostic factors of Guillain-Barré syndrome in a pediatric cohort.
- To identify predictors of recovery and long-term sequelae in children with GBS.
- To provide insights into the natural history of pediatric GBS.
Summary:
- This retrospective study reviewed 71 pediatric Guillain-Barré syndrome cases, noting infection preceded 50% of cases.
- Key findings include a mean age of 5.5 years, sudden onset in 65%, and significant motor deficits.
- Cerebrospinal fluid protein elevation was common (73%), with 53% regaining motility within a month; however, 31% had residual deficits after 3+ years.
Impact:
- The study highlights the variability in pediatric Guillain-Barré syndrome presentation and recovery.
- Identifies age, extension phase duration, and plateau phase duration as critical prognostic factors.
- Informs clinical management and counseling for families regarding GBS outcomes in children.
Abstract:
The authors report a retrospective study of 71 cases of Guillain-Barré syndrome in children. The sex ratio was 1.2/1 and the mean age 5.5 years. A history of infection preceded the polyradiculoneuritis in 50% of the cases. Sudden onset was observed in 65%. The mean duration of extensive phase was 6 days (1-20) and the mean duration of the maximum paralysis was 18 days (3-90). A quadriplegia was present in 30 cases, a severe respiratory involvement in 6 cases, a cranial nerve paralysis in 7 cases. An early raised cerebrospinal fluid protein concentration was found in 73%. The motility recuperation time was one month in 53%. A one year follow-up was obtained in 45 patients and 62% had completely recovered clinically. Four patients died, two from respiratory failure, one from autonomic neuropathy, and one from cerebral haemorrhage with associated idiopathic thrombocytopenic purpura. Thirty-two children were followed-up during 3 years and more, 10 (31%) had residual deficits. The functional prognostic factors were the age, the duration of the extension phase and of the plateau phase.