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Published on: November 9, 2017
Association Between A-Waves and Outcome in Pediatric Guillain-Barré Syndrome
Mei Jin1, Jing Liu1, Ziwei Zhao1
1Department of Pediatric Neurology, Children's Hospital of Hebei Province, Shijiazhuang, China.
Insights
In pediatric Guillain-Barré Syndrome (GBS), abundant A-waves indicate demyelination and predict a worse short-term prognosis in children with the acute inflammatory demyelinating polyneuropathy (AIDP) subtype.
Area of Science:
- Neurology
- Pediatric Neurology
- Clinical Electrophysiology
Background:
- Guillain-Barré Syndrome (GBS) is a rare autoimmune disorder affecting the peripheral nervous system.
- Accurate electrophysiological classification and prognostic markers are crucial for managing pediatric GBS.
- A-waves, an electrophysiological finding, have been inconsistently studied in pediatric GBS prognosis.
Purpose of the Study:
- To investigate the significance of abundant A-waves in the electrophysiological classification and prognosis of pediatric GBS.
- To determine if A-waves can serve as an early predictor of outcome in children with GBS.
Main Methods:
- A retrospective study of 65 children (≤16 years) diagnosed with GBS.
- Patients were categorized based on the presence or absence of abundant A-waves.
- Functional disability (Hughes grade) was assessed at nadir, 1 month, and 6 months post-onset.
Main Results:
- Patients with GBS and A-waves exhibited significantly prolonged distal motor latency (9.18 ms vs. 4.1 ms).
- The presence of A-waves was linked to a worse short-term prognosis in the acute inflammatory demyelinating polyneuropathy (AIDP) subtype of GBS (p=0.025).
- A-waves were statistically associated with demyelination and predicted poorer outcomes (OR: 5.844, p=0.036).
Conclusions:
- Abundant A-waves are strongly associated with demyelination in pediatric GBS.
- A-waves serve as a significant indicator of poor short-term prognosis in pediatric AIDP.
- This study proposes A-waves as a valuable electrophysiological marker for predicting outcomes in pediatric AIDP.
Introduction:
To examine the importance of abundant A-waves in electrophysiological classification and prognosis of pediatric Guillain-Barré Syndrome (GBS).
Methods:
A single-center and retrospective study enrolling 65 children-patients, aged 16 years and younger, with clinically diagnosed GBS between 2013 to 2020. Hughes grade was used to assess functional disability at nadir, 1 month, and 6 months after symptom onset. Patients were divided into 2 groups according to the presence of abundant A-waves. Clinical features and prognosis between the 2 groups were compared.
Results:
The distal motor latency of the median nerve in patients with GBS with A-waves (9.18 ms) was more prolonged than that of patients with GBS without A-waves (4.1 ms). An electrophysiological variant of these two groups was also statistically different (p = 0.006). The short-term prognosis of patients with AIDP with A-waves was worse than patients with AIDP without A-waves (χ2 = 5.022, p = 0.025), and univariable logistic regression analysis showed statistically significant (OR: 5.844, 95% CI 1.118-30.553; p = 0.036).
Conclusion:
A-waves were strongly associated with demyelination and poor short-term prognosis of AIDP in children. We proposed an electrophysiological marker for early prediction of outcome in the AIDP subtype of GBS, applicable for clinical practice and future treatment administration.
