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Published on: November 9, 2017
Long-term outcomes of paediatric Guillain-Barré syndrome
Bastien Estublier1, Hélène Colineaux2,3, Catherine Arnaud2,3
1Neuropediatric Department, Toulouse-Purpan University Hospital, Toulouse, France.
Insights
Two-thirds of children with Guillain-Barré syndrome (GBS) experience long-term sequelae, often minor but sometimes impacting daily life. Severe initial GBS and female sex predict worse outcomes.
Area of Science:
- Pediatric Neurology
- Neuromuscular Disorders
- Clinical Pediatrics
Background:
- Guillain-Barré syndrome (GBS) is an autoimmune disorder affecting the peripheral nervous system.
- Long-term outcomes in pediatric GBS patients require further investigation.
- Understanding sequelae is crucial for comprehensive patient management.
Purpose of the Study:
- To investigate the prevalence and nature of long-term sequelae in children following GBS.
- To identify factors associated with the development and severity of these sequelae.
Main Methods:
- Prospective observational study conducted in two French tertiary centers.
- Inclusion of 51 children diagnosed with GBS.
- Data collection via clinical assessments and standardized scales/questionnaires over a median follow-up of 6 years and 4 months.
Main Results:
- A 67% rate of long-term sequelae was observed, with most being minor (GBSDS=1).
- Common complaints included paresthesia (43%), pain (35%), and fatigue (31%).
- Initial GBS severity (GBSDS>4) and female sex predicted more severe late-onset conditions.
Conclusions:
- Two-thirds of children with GBS experience persistent sequelae, often minor but with potential daily life repercussions.
- Severe GBS during the acute phase is a significant predictor of worse long-term outcomes.
- Early identification of risk factors is essential for targeted interventions in pediatric GBS.
Aim:
To study long-term sequelae in children with Guillain-Barré syndrome (GBS).
Method:
This was a prospective observational study with children from two French tertiary centres. Data were from clinical and several standardized scales or questionnaires.
Results:
Fifty-one patients were included with a median follow-up of 6 years 4 months (range 3-20 years) after the acute phase. The sequelae rate was 67% (95% confidence interval [CI] 53-78) and did not vary with time. Most children had minor sequelae (Guillain-Barré Syndrome Disability Score [GBSDS] = 1); only one was unable to run (GBSDS = 2). The most frequent complaints were paraesthesia (43%), pain (35%), and fatigue (31%). The neurological examination was abnormal in 18% of children, autonomy was compromised in 14%, and symptoms of depression occurred in 34%. The factors associated with late-onset sequelae were correlated with severity during the initial phase (i.e. initial GBSDS >4, odds ratio 6.6, 95% CI 1.8-33; p = 0.009). The predictive factors of more severe late-onset conditions were initial severity (p = 0.002) and sex (female patients; p = 0.01).
Interpretation:
Two-thirds of children with GBS had late-onset sequelae following an episode, often minor, but sometimes with continuing effects on their everyday lives. Particularly affected were those who had severe GBS during the acute phase and who lost the ability to walk.
What This Paper Adds:
Two-thirds of children with Guillain-Barré syndrome (GBS) had persistent sequelae. Sequelae were often minor, but daily repercussions of them were sometimes serious. Sequelae were significantly associated with severe GBS during the acute phase.
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