Acute inflammatory demyelinating polyradiculopathy in children : a clinical and electrophysiological study

Over a period of eight years (1985-1992) 79 children who fulfilled NINDS criteria for GB Syndrome were evaluated at National Institute of Mental Health and Neuro Sciences, (NIMHANS), Bangalore, India. There were 58 boys and 21 girls constituting 29.2percent of the total cases of GB Syndrome seen during the same period. One third of them were below 5 years of age. Antecedent events were noted in 41.9 percent and peak motor deficit was reached in over 90 percent cases within tow weeks. At admission besides quadripareresis and hyproflexia, facial (49.4 percent), bulbar (32.9 percent) and respiratory muscle weakness(8.9 percent) sensory disturbances (32.1 percent) and autonomic dysfunction (11.5 percent) of varying severity were also noted. Two elve patients needed ventilators assistance at the peak of illness and there were five deaths. Albuminocytological dissociation was present in 61.7 percent. Electrophysiological abnormalities were almost universal, involved motor and sensory nerves and were observed even in first week of illness. Comparison with adults with GB Syndrome revealed that bulbar and respiratory muscle weakness and sensory and autonomic disturbances were more common in adults, however CSF and electrophysiological abnormalities were equally frequent in both the groups. GB Syndrome constitute an important cause of flaccid paralysis in children. Clinical profile in children, but for minor variations is essentially the same as in adults. High incidence of sensory conduction abnormalities even during early part of illness may be useful in differentiating it from other causes of neuroparalytic illness in childhood.