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Retrospective evaluation of Guillain-Barre syndrome in children: A single-center experience
Yiğithan Güzin1, Unsal Yılmaz2, Serdar Pekuz2
1Department of Pediatric Neurology, University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey.
Insights
Monitoring the Guillain-Barré syndrome (GBS) disability score (DS) helps predict long-term outcomes in children. A higher 3-month DS indicates a greater risk of developing lasting GBS sequelae.
Area of Science:
- Pediatric Neurology
- Neuromuscular Disorders
- Clinical Outcomes Research
Background:
- Guillain-Barré syndrome (GBS) is the leading cause of acute flaccid paralysis in children.
- Long-term follow-up data for pediatric GBS remains limited.
- Identifying prognostic factors is crucial for optimizing treatment and patient management.
Purpose of the Study:
- To assess the predictive value of the GBS disability score (DS) for morbidity and mortality in children.
- To evaluate the effectiveness of DS monitoring in long-term GBS follow-up.
Main Methods:
- Patients were stratified into two groups based on admission DS (≥3 vs. <3).
- Demographic, clinical, and laboratory data were collected.
- DS was recorded at admission and at 1, 3, 6, 12, and 24 months post-admission.
Main Results:
- The study included 44 pediatric patients (median age 5 years).
- Common manifestations included weakness, ataxia, neuropathic pain, cranial neuropathy, respiratory distress, autonomic dysfunction, and psychiatric symptoms.
- A higher admission DS (≥3) correlated with shorter symptom onset-to-admission time and longer hospital stays.
- Children with back pain and autonomic dysfunction presented with a DS of ≥3.
- A high 3-month DS was a significant predictor of sequelae development.
Conclusions:
- GBS can present with atypical symptoms like hemiplegia and ophthalmoplegia, beyond typical weakness and gait issues.
- The DS is a valuable tool for objectively assessing motor function and clinical improvement during pediatric GBS follow-up.
Background:
Although Guillain-Barré syndrome (GBS) is now the most common cause of acute flaccid paralysis in children, information on the long-term follow-up of GBS is still limited. Identification of prognostic factors can play an important role in treatment strategies and the follow-up of patients. This study aimed to evaluate the effectiveness of monitoring the GBS disability score (DS) in predicting morbidity and mortality.
Methods:
The patients were separated into two groups those with DS≥ or <3 on admission. These groups were compared in respect of demographic data, clinical and laboratory findings, and the DS recorded on admission and at first, third, sixth, 12th, and 24th months.
Results:
The study included 44 patients (54.5% male, 45.5% female) with a median age of 5 years. The most common involvements during the disease were weakness, ataxia, neuropathic pain, cranial neuropathy, respiratory distress, autonomic dysfunction, and psychiatric symptoms, respectively. In patients with a DS of ≥3, the time from onset of symptoms to hospital admission was shorter, and the length of hospital stay was longer. Children with back pain and autonomic dysfunction had a DS of ≥3. A high 3-month DS was found to be a significant predictor for the development of sequelae.
Conclusions:
Although progressive muscle weakness and inability to walk are the most common symptoms of GBS, it should be kept in mind that atypical manifestations such as hemiplegia and ophthalmoplegia may also occur. For an objective assessment of clinical improvement during follow-up, the DS for motor functions can be used.
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