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Predictive factors for achieving independent walking in children with Guillain-Barre syndrome
Mohammad Barzegar1, Vahideh Toopchizadeh2, Mohammad H K Maher1
1Pediatric Health Research Center, Department of Pediatrics, Tabriz University of Medical Science, Tabriz, Iran.
Insights
Predictors of independent walking in children with Guillain-Barre syndrome (GBS) were identified. Cranial nerve involvement and absent compound muscle action potential (CMAP) were key factors impacting recovery, highlighting the need for early intervention.
Area of Science:
- Pediatric Neurology
- Neuromuscular Disorders
- Rehabilitation Medicine
Background:
- Guillain-Barre syndrome (GBS) is a rare autoimmune disorder affecting children.
- Assessing predictors of functional recovery, specifically independent walking, is crucial for pediatric GBS management.
- Understanding factors influencing walking ability aids in targeted rehabilitation strategies.
Purpose of the Study:
- To identify predictors for achieving independent walking at 2 and 6 months post-onset in pediatric Guillain-Barre syndrome (GBS).
- To analyze factors associated with delayed or impaired walking recovery in children with GBS.
Main Methods:
- Prospective study of 324 children with GBS admitted to Tabriz Children's Hospital.
- Regular clinical evaluations were conducted until independent walking was achieved.
- Univariate and multivariate analyses were employed to determine influencing factors on walking outcomes.
Main Results:
- The mean time to independent walking was approximately 3 months, with 90.5% achieving it by 6 months.
- Factors associated with poor walking outcome included a disability score >3, autonomic nerve involvement, cranial nerve involvement, and absent compound muscle action potential (CMAP).
- Multivariate analysis confirmed cranial nerve involvement and absent CMAP as independent predictors of poor functional outcome.
Conclusions:
- Disability score >3, cranial nerve involvement, autonomic nerve involvement, and absent CMAP predict independent walking in childhood GBS.
- Early rehabilitation programs are recommended to prevent secondary impairments from immobility in pediatric GBS patients.
- Identifying these predictors can guide prognosis and therapeutic interventions for better patient outcomes.
Abstract:
BackgroundTo determine the predictors of achieving independent walking at 2 and 6 months after onset of weakness in children with Guillain-Barre syndrome (GBS).MethodsChildren with GBS admitted to the Tabriz Children's Hospital were studied prospectively. All patients had frequent clinical evaluations until achieving independent walking. Unaided walking at 2 and 6 months and factors influencing these outcomes were determined using both univariate and multiple analyses.ResultsBetween 2003 and 2014, 324 children (mean age: 5.3±3.66 years) were admitted. The mean duration to independent walking was 2.97±3.02 months; 90.5% of patients could walk independently at 6 months. In the univariate analysis, disability score of >3 (P=0.03), autonomic nerve involvement (P=0.003), cranial nerve involvement (P=0.008), and absent compound muscle action potential (CMAP; P=0.048) were found to be significantly associated with poor walking outcome at 6 months. In the multivariate analysis, cranial nerve involvement (P=0.008) and absence of CMAP (P=0.022) were independently associated with poor functional outcome.ConclusionDisability score >3, cranial and autonomic nerve involvement, and absence of CMAP were predictors of independent walking in childhood GBS in this study; early rehabilitation program may prevent further impairments secondary to immobility in these patients.
