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Clinical Features and Outcome of Guillain-Barré Syndrome in Children
Jafar Nasiri1, Mohamadreza Ghazavi1, Omid Yaghini1
1Department of Pediatric Neurology, Faculty of Medicine, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Insights
Guillain-Barré syndrome (GBS) in children commonly presents with lower limb weakness, reduced reflexes, and pain. Most children recover fully, but autonomic dysfunction can lead to severe outcomes, highlighting the need for critical care.
Area of Science:
- Pediatric Neurology
- Clinical Neuroscience
- Epidemiology
Background:
- Guillain-Barré syndrome (GBS) is a rare neurological disorder.
- Limited data exists on GBS clinical presentations and outcomes in Isfahan, Iran.
Purpose of the Study:
- To describe the clinical features and outcomes of pediatric Guillain-Barré syndrome in Isfahan, Iran.
- To provide regional data on GBS in children.
Main Methods:
- Retrospective analysis of medical records from 2011-2014.
- Inclusion of 57 children diagnosed with GBS at a pediatric referral center.
- Data extraction included demographics, symptoms, neurological findings, and outcomes.
Main Results:
- GBS was more frequent in boys (61.4%) than girls (38.6%).
- Common symptoms included distal lower limb weakness (92.11%), reduced deep tendon reflexes (82.46%), and neuropathic pain (75.44%).
- Complete recovery was observed in 92.9% of patients.
Conclusions:
- Distal lower limb weakness, reduced DTR, and neuropathic pain are key GBS presentations in children.
- Autonomic dysfunction is linked to severe outcomes and necessitates critical care.
- Potential need to revise diagnostic criteria for GBS.
Objective:
There are no reports about the clinical presentations and outcome of Guillain-Barré syndrome (GBS) in our region, therefore, we aimed to report some mentioned findings in children diagnosed with GBS in Isfahan, central Iran.
Materials & Methods:
In this retrospective study, pediatric diagnosed with GBS referred to Imam Hossein Hospital, the Pediatric Referral Center of Isfahan Province, central Iran were enrolled from 2011-2014. The following data were extracted from the medical files of patients; age, gender, early signs and symptoms of GBS, neurological features, sensory and motor and autonomic involvements, sphincter dysfunction, bulbar muscle involvement, respiratory failure, cranial nerve paralysis, delay time from onset to definite diagnosis and management of GBS and the outcome.
Results:
Overall, 57 children with GBS aged 1-13 yr were evaluated. Frequency of GBS was significantly higher in boys than in girls (38.6% vs. 61.4%, P=0.01, OR=0.39). The most common clinical presentations were distal lower limb weakness (92.11%), reduced deep tendon reflex (DTR) (82.46%) and neuropathic pain (75.44%). 92.9% of patients had complete recovery.
Conclusion:
Distal lower limb weakness, reduced deep tendon reflex, and neuropathic pain are the main clinical presentation in children with GBS but in some patients, DTR may be normal or even exaggerated in early stage of disease. Revising the diagnostic criteria for GBS may be necessary. Most of our patients had complete recovery. The only death was due to autonomic involvement. Autonomic dysfunction could be associated with catastrophic outcome and patients with these clinical presentations need critical care.
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