Clinical Profile and Outcome of Guillain-Barre Syndrome in Pediatric Patients Admitted to a Tertiary Care Centre: A Retrospective Study
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Published on: January 12, 2019
Ramya Srinivasa Rangan1, Milind S Tullu1, Chandrahas T Deshmukh1
1Department of Pediatrics, Seth G.S. Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India.
Insights
Pediatric Guillain Barre Syndrome (GBS) often follows gastrointestinal illness, presenting with lower limb weakness. Autonomic disturbances are common complications and predict higher mortality in children with GBS.
Area of Science:
- Pediatric Neurology
- Clinical Neuroscience
- Immunology
Background:
- Guillain Barre Syndrome (GBS) is an autoimmune disorder affecting the peripheral nervous system.
- Pediatric GBS presents unique challenges in diagnosis and management.
- Understanding the clinical profile and outcomes is crucial for improving patient care.
Purpose of the Study:
- To investigate the clinical characteristics and outcomes of pediatric Guillain Barre Syndrome.
- To identify common presenting symptoms, antecedent illnesses, and complications.
- To determine factors associated with mortality in pediatric GBS.
Main Methods:
- A retrospective study of 30 pediatric patients diagnosed with GBS over two years.
- Data collected included clinical presentation, antecedent illnesses, diagnostic findings (MRI, nerve conduction studies), treatment, and outcomes.
- Statistical analysis was performed to identify predictors of mortality.
Main Results:
- The most common presentation was symmetrical lower limb weakness (86.67%).
- Gastrointestinal illness was the most frequent antecedent infection (6 cases).
- Pneumonia and autonomic disturbances were the most common complications, with autonomic disturbances predicting higher mortality (P = 0.034).
Conclusions:
- Gastrointestinal illness frequently precedes GBS in children.
- Symmetrical lower limb weakness is the hallmark symptom.
- Autonomic dysfunction is a significant complication associated with increased mortality in pediatric GBS.
Aims And Objectives:
To study clinical profile and outcome in Pediatric Guillain Barre Syndrome (GBS).
Materials And Methods:
Retrospective study of 30 patients (age 1 month to 12 years) admitted with GBS enrolled over a period of 2 years (August 2016-July 2018) from Department of Pediatrics of tertiary centre.
Results:
Mean age was 5.4 years (21 males; 9 females). Most common presenting complaints- symmetrical lower limb weakness (26 cases; 86.67% cases), respiratory complaints (6 cases; 20% cases), quadriparesis (4 cases; 13.33% cases) and facial palsy (2 cases; 6.67%). Antecedent illnesses- gastrointestinal (6 cases) and respiratory (3 cases). Two patients had varicella (in preceding one week) and one had mumps (one month prior to presentation). MRI-spine done in 12 patients; of whom 9 had features of GBS (thickening and contrast enhancement of the intrathecal and cauda equina nerve roots on T1 weighted MRI). Nerve conduction studies done in 16 patients, of which Acute Motor Axonal Neuropathy was seen in 10 cases. Intravenous immunoglobulin was given to 27 patients while 3 received methylprednisolone in addition. 90% patients receiving IVIG showed improvement. Sixteen patients were admitted to the intensive care unit and 7 required mechanical ventilation. Average hospital stay was 13 days. Two patients had recurrent episodes. Common complications included- pneumonia (6 cases; 2 aspiration and 4 ventilator associated) and autonomic disturbances (6 cases). Two patients died due to autonomic disturbances and presence of autonomic disturbances predicted higher mortality (P = 0.034).
Conclusions:
Gastrointestinal illness was common antecedent illness for GBS. Symmetrical lower limb weakness was commonest complaint. Pneumonia and autonomic disturbances were commonest complications. Presence of autonomic disturbances predicted higher mortality.
