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Fine Motor Outcomes in Children with Guillain-Barré Syndrome
Ashna Kumar1, Lokesh Saini2, Pradeep Kumar Gunasekaran3
1Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, 342005, India.
Insights
Most children with Guillain-Barré syndrome (GBS) recover, but some experience long-term motor deficits affecting daily activities. Early monitoring of these persistent GBS sequelae is crucial for improving quality of life.
Area of Science:
- Pediatric Neurology
- Neuromuscular Disorders
Background:
- Guillain-Barré syndrome (GBS) is an autoimmune disorder affecting the peripheral nervous system.
- While many children recover, long-term motor outcomes require further investigation.
Purpose of the Study:
- To assess the motor outcomes in children with GBS at 6-month and 1-year follow-up.
- To identify persistent motor deficits and their impact on daily activities.
Main Methods:
- An ambispective study involving children diagnosed with GBS.
- Motor function was evaluated using the Hughes Guillain-Barré Syndrome Disability Score (GBSDS) and Overall Neuropathy Limitations Scale (ONLS) at discharge, 6 months, and 1 year.
Main Results:
- Of 52 children, significant motor deficits (GBSDS ≥ 2) persisted in 19.2% at 1 year.
- At discharge, 46.2% had arm score > 2 and 86.5% had leg score > 2 on ONLS.
- By 1 year, arm and leg scores improved, but 7.7% and 9.7% respectively still showed limitations.
Conclusions:
- Complete recovery is common, but long-term fine motor impairments can affect daily life in children with GBS.
- Early identification and monitoring of persistent motor deficits are essential for optimizing quality of life.
Objectives:
To study the motor outcomes at 6-mo and 1-y follow-up of children with Guillain-Barré syndrome (GBS).
Methods:
This study was an ambispective study of 12 mo duration including children with GBS. The motor outcomes were assessed using Hughes Guillain-Barré Syndrome Disability Score (GBSDS) and Overall Neuropathy Limitations Scale (ONLS) at discharge, 6-mo, and 1-y follow-up.
Results:
Of 56 patients enrolled, 52 children were included in the study. The median (IQR) age at presentation was 8 (4-11) y. Acute motor axonal neuropathy (AMAN) was the most common variant (50%) in the study. At discharge, all the children had GBSDS ≥ 2, with 51.9% (27/52) patients at 6-mo follow-up, and 19.2% (10/52) had GBSDS ≥ 2 at 1-y follow-up, signifying the need for assistance. On ONLS assessment, 46.2% (24/52) had an arm score of > 2, and 86.5% (45/52) had a leg score of > 2 at discharge. At 6-mo follow-up, 26.9% (14/52) had an arm score > 2, and 19.2% (10/52) had a leg score > 2. At 1-y follow-up, 7.7% (4/52) had an arm score of > 2, and 9.7% (5/52) had a leg score > 2. There was no mortality in the index study.
Conclusions:
Though most children with GBS recover completely, there can still be long-term impairments of fine motor movements required for daily activities. Early recognition and monitoring of persistent motor deficits as long-term sequelae of GBS is of utmost importance to improve the quality of life of these children.
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