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Guillain-Barre syndrome in infants and children
Insights
Guillain-Barre syndrome (GBS) in children is rare but treatable. Most pediatric GBS patients fully recover with supportive care, highlighting the importance of early diagnosis and intervention for a good prognosis.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Clinical Research
Background:
- Guillain-Barre syndrome (GBS) incidence is low in children, affecting 0.4-1.7 per 100,000 annually.
- This study focuses on fifteen Chinese pediatric GBS cases due to its rarity in this age group.
Purpose of the Study:
- To investigate the clinical characteristics, triggers, and outcomes of Guillain-Barre syndrome in Chinese infants and children.
- To understand the role of infectious agents in pediatric GBS pathogenesis.
Main Methods:
- Retrospective analysis of hospital records for fifteen pediatric GBS patients (1-16 years old).
- Assessment of clinical severity using the GBS Study Group scale (Grades 2-5).
- Review of preceding illnesses, cerebrospinal fluid (CSF) analysis, serological tests, and electrophysiological studies.
Main Results:
- 46.7% of patients had preceding viral illness (mean 12 days prior).
- Common symptoms included weakness, areflexia, pain, and paresthesia; CSF showed elevated protein with mild pleocytosis.
- Epstein-Barr virus and Mycoplasma pneumoniae were identified in some patients; all showed demyelination on nerve conduction studies.
- Most patients received supportive care, with 3 requiring mechanical ventilation; all achieved full recovery within 3.4 months.
Conclusions:
- Infectious pathogens are implicated in the development of GBS in children.
- Complete recovery is the typical outcome for pediatric GBS patients, emphasizing favorable prognosis with appropriate management.
Background:
Guillain-Barre syndrome (GBS) occurs at all ages, and population-based studies give it a crude average annual incidence rate ranging from 0.4 to 1.7 per 100,000 population. This retrospective study is performed for fifteen Chinese infants and children in light of the fact that GBS infrequently occurs during childhood years.
Methods:
Hospital records of fifteen Chinese infants and children, i.e. eleven males and four females, with GBS were included. Their ages ranged from one to sixteen years old, with a mean average of 8.5 years. Their performances were graded on a scale from 0 to 6 according to the GBS Study Group. Their performances were graded under categories of Grades 2 (2/15), 3 (2/15), 4 (8/15) and 5 (3/15).
Results:
Seven patients (46.7%) had preceding viral illness, occurring from seven to fourteen days prior to admission, with a mean average of twelve days. In addition to weakness and areflexia, musculoskeletal pain and subjective paresthesia were the most common presentations upon admission. The later the cerebrospinal fluid (CSF) was examined, the more cases had CSF features of increased protein level with no or mild pleocytosis. Eleven patients underwent serological examinations, and seven of their tests yielded positive for Epstein-Barr virus in five and Mycoplasma pneumoniae in two. Seven patients underwent electromyography and nerve conduction velocity measurement, all exhibiting the characteristic features of demyelination. Twelve patients had supportive treatment, and three of them required mechanical ventilation. Intravenous gamma globulin was administered in two patients, and oral prednisolone was administered in one patient. It took one to six months with a mean average of 3.4 months for patients' performance returning to Grade 0. All of the patients survived without residual disability.
Conclusions:
Some infectious pathogens could play a role in the pathogenesis of GBS. Furthermore, complete recovery may be the rule for most infants and children with GBS.