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Kozyreva AA, Bembeeva RT, Druzhinina ES, Zavadenko NN. [Guillain-Barre syndrome in children]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:20-32. [PMID: 37942969 DOI: 10.17116/jnevro202312309220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Guillain-Barré syndrome (GBS) is an immune-mediated disease of the peripheral nervous system that can occur in both children and adults. The classic presentation of GBS is characterized by progressive symmetrical, ascending muscle weakness. Patients with GBS require meticulous monitoring due to the risk of bulbar syndrome, respiratory failure and autonomic dysfunction, which can be life-threatening. Early diagnosis and timely prescription of pathogenetic therapy for GBS are particularly important, especially in young children. Meanwhile, the spectrum of disorders covered by GBS has expanded significantly; its eponym is now designate any variant of acute dysimmune polyneuropathy, and its atypical forms pose a serious diagnostic problem for clinicians. This review article provides an analysis of the data available in the medical literature on GBS in children and discusses the tactics for diagnosing and managing patients with GBS, taking into account the Russian and European clinical recommendations.
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Affiliation(s)
- A A Kozyreva
- Pirogov Russian National Research Medical University, Moscow, Russia
- Russian Children's Clinical Hospital, Moscow, Russia
| | - R Ts Bembeeva
- Pirogov Russian National Research Medical University, Moscow, Russia
- Russian Children's Clinical Hospital, Moscow, Russia
| | - E S Druzhinina
- Pirogov Russian National Research Medical University, Moscow, Russia
- Russian Children's Clinical Hospital, Moscow, Russia
| | - N N Zavadenko
- Pirogov Russian National Research Medical University, Moscow, Russia
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Whelan AJ, Tolaymat A, Rainey SC. Bumbling, Stumbling, Fumbling: Weakness, Steppage Gait, and Facial Droop in a 3-Year-Old Male. Glob Pediatr Health 2019; 6:2333794X19865858. [PMID: 31384634 PMCID: PMC6657125 DOI: 10.1177/2333794x19865858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 06/10/2019] [Accepted: 06/26/2019] [Indexed: 11/16/2022] Open
Abstract
A previously healthy, unimmunized, 3-year-old Caucasian boy presented to the emergency department with right-sided facial droop, clumsiness, and intermittent bilateral hip pain. Two weeks ago, he had 24 hours of self-resolving rhinorrhea and fever. Examination was significant for right facial nerve palsy, lower extremity pain, areflexia of his right lower extremity, and diminished reflexes of his left lower extremity. He was admitted for urgent magnetic resonance imaging of the brain. Cerebrospinal fluid (CSF) protein was 85 mg/dL with elevated albumin and immunoglobulin, and CSF white blood cell was 3 cells/mm3. Serum Mycoplasma immunoglobulin (Ig) M and IgG were elevated. There was concern for Guillain-Barré syndrome (GBS). He was started on intravenous IG (IVIG) and was treated for presumed Mycoplasma infection. Weakness and gait disturbances in a child can present the clinician with a diagnostic challenge. Gait disturbance may indicate a neurological lesion anywhere from the central nervous system to the peripheral nerves, neuromuscular junction, or muscle. In the present case, the combination of peripheral facial palsy, presumed neuropathic pain, gait difficulties, and areflexia in the setting of an antecedent respiratory illness were suggestive of GBS. The cornerstone treatments involve hospitalization to facilitate continuous monitoring for serious sequelae, such as acute respiratory failure and cardiac dysrhythmia, followed by immunotherapy with IVIG or plasma exchange. Gait disturbance and weakness in a child is a diagnostic challenge. GBS is the most common cause of acute paralysis in the Western world and should remain high on the clinician's differential diagnosis. However, patients with GBS may also present nonclassically with extremity pain and cranial nerve palsies.
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Affiliation(s)
- Aviva J Whelan
- University of Illinois College of Medicine at Peoria, Peoria, IL, USA
| | - Abdullah Tolaymat
- University of Illinois College of Medicine at Peoria, Peoria, IL, USA
| | - Shane C Rainey
- University of Illinois College of Medicine at Peoria, Peoria, IL, USA
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Sharma K, Tengsupakul S, Sanchez O, Phaltas R, Maertens P. Guillain-Barré syndrome with unilateral peripheral facial and bulbar palsy in a child: A case report. SAGE Open Med Case Rep 2019; 7:2050313X19838750. [PMID: 30915222 PMCID: PMC6429638 DOI: 10.1177/2050313x19838750] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 02/27/2019] [Indexed: 12/29/2022] Open
Abstract
Guillain-Barré syndrome is characterized by progressive motor weakness, sensory changes, dysautonomia, and areflexia. Cranial nerve palsies are frequent in Guillain-Barré syndrome. Among cranial nerve palsies in Guillain-Barré syndrome, facial nerve palsy is the most common affecting around half of the cases. Facial palsy in Guillain-Barré syndrome is usually bilateral. We describe a pediatric Guillain-Barré syndrome variant presenting with unilateral peripheral facial palsy and dysphagia. A 5-year-old boy had progressive lower extremity weakness and pain 3 days prior to onset of unilateral peripheral facial palsy. On presentation, diagnosis of Guillain-Barré syndrome was supported by areflexia and albuminocytologic dissociation. His condition deteriorated with a decline in his respiratory effort and inability to handle secretions. He was given non-invasive ventilation to prevent worsening of his acute respiratory failure. Brain and spine magnetic resonance imaging scans showed enhancement of the left bulbar nerve complex and anterior and posterior cervical nerve roots with gadolinium. Treatment with intravenous immunoglobulin led to an uneventful clinical course with partial recovery within 2 weeks. In summary, Guillain-Barré syndrome should be considered as a possible cause of unilateral peripheral facial palsy. Guillain-Barré syndrome patients with facial nerve and bulbar palsy require close monitoring as they are at risk of developing acute respiratory failure. Early intervention with intravenous immunoglobulin may benefit these patients. Magnetic resonance imaging findings may lend support to early intervention.
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Affiliation(s)
- Kamal Sharma
- Division of Pediatric Critical Care, Department of Pediatrics, College of Medicine, University of South Alabama, Mobile, AL, USA
| | - Supatida Tengsupakul
- Division of Pediatric Infectious Disease and Pediatric Hospitalist Service, College of Medicine, University of South Alabama, Mobile, AL, USA
| | - Omar Sanchez
- Division of Pediatric Critical Care, Department of Pediatrics, College of Medicine, University of South Alabama, Mobile, AL, USA
| | - Rozaleen Phaltas
- Department of Pediatrics, College of Medicine, University of South Alabama, Mobile, AL, USA
| | - Paul Maertens
- Department of Neurology, College of Medicine, University of South Alabama, Mobile, AL, USA
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Abstract
Differentiating Guillain-Barré syndrome (GBS) from inherited neuropathies and other acquired peripheral neuropathies requires understanding the atypical presentations of GBS and its variant forms, as well as historical and physical features suggestive of inherited neuropathies. GBS is typically characterized by the acute onset of ascending flaccid paralysis, areflexia, and dysesthesia secondary to peripheral nerve fiber demyelination. The disorder usually arises following a benign gastrointestinal or respiratory illness, is monophasic, reaches a nadir with several weeks, and responds to immunomodulatory therapy. Inherited neuropathies with onset before adulthood, whose presentation may mimic Guillain-Barré syndrome, are reviewed.
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Affiliation(s)
- Brett J Bordini
- Department of Pediatrics, Section of Hospital Medicine, Nelson Service for Undiagnosed and Rare Diseases, Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Priya Monrad
- Department of Child and Adolescent Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
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Weakness and the inability to ambulate in a 14-month-old female: a case report and concise review of guillain-barre syndrome. Case Rep Emerg Med 2013; 2013:953612. [PMID: 23431480 PMCID: PMC3572648 DOI: 10.1155/2013/953612] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Accepted: 01/10/2013] [Indexed: 11/17/2022] Open
Abstract
Guillain-Barre syndrome (GBS) is an acquired disease of the peripheral nervous system which causes demyelination and leads to weakness, ataxia, and areflexia. There are a variety of forms of the syndrome, and although it is found in all age groups, it is rare in children less than two years of age. The present complaint of weakness, ataxia, or lower extremity pain in the pediatric population should cause the practitioner to consider GBS in the differential. We describe a case of a 14-month-old girl presenting with weakness and the inability to ambulate who was diagnosed with GBS. The purpose of this paper is to review the emergency medicine diagnosis and management of Guillain-Barre syndrome in children.
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Hirji N, Shouls G, Ali N. The Risk of Neuroblastoma in Paediatric Horner Syndrome—A Systematic Reappraisal of the Literature. Neuroophthalmology 2012. [DOI: 10.3109/01658107.2012.730094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
This investigation correlated incidence and degree of autonomic dysfunction with the degree of motor impairment in children hospitalized with Guillain-Barré syndrome. Motor weakness varies, as does the effect on autonomic function including heart rate, vasomotor stability, sweating, continence, and blood pressure. After Institutional Review Board approval, hospitalized patients with Guillain-Barré syndrome <19 years were included for retrospective chart review. There were 26 patients (12 boys), with a mean age of 11.3 years (range, 6-17 years). The average hospital stay was 10.6 days. Twenty-four (92%) recovered by 2 to 6 months without functional disability. Bradycardia and sweating disturbances were not observed. Hypertension occurred in 18 of 26 (69%) and tachycardia in 20 of 26 (77%) patients. The proportion of children with hypertension and/or tachycardia increased, as did the motor disability grade (P < .043 and P < .018, respectively). Hypertension occurred 9 to 15 days from symptom onset and within 24 to 48 hours of maximum motor disability in 89%. Multiple autonomic disturbances compound the course of childhood Guillain-Barré syndrome.
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Affiliation(s)
- Francis J Dimario
- Division of Neurology, Department of Pediatrics, The University of Connecticut School of Medicine, Connecticut Children's Medical Center, Hartford, CT, USA
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Tremblay ME, Closon A, D'Anjou G, Bussières JF. Guillain-Barré syndrome following H1N1 immunization in a pediatric patient. Ann Pharmacother 2010; 44:1330-3. [PMID: 20484170 DOI: 10.1345/aph.1p078] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE To report a case of Guillain-Barré syndrome (GBS) following a dose of influenza A (H1N1) vaccine (Arepanrix). CASE SUMMARY An 11-year-old boy was admitted to the hospital after presenting with facial diplegia; abdominal, forehead, and thigh pain; and acute cervical pain. He had received the Arepanrix H1N1 subcutaneous vaccine 13 days before symptom onset. The neurologic examination also revealed a symmetric bilateral paralysis of the VIIth cranial nerve and intense pain, proximal weakness of the shoulder girdles and pelvis, and preserved deep tendon reflexes. Cerebrospinal fluid analysis revealed an albuminocytologic dissociation. Therefore, a diagnosis of atypical GBS following vaccination against HINI influenza was made. DISCUSSION Based on the clinical evaluation, laboratory test results, neurologic features, and the exclusion of alternative diagnoses, the Naranjo probability scale revealed a probable relationship between the clinical manifestations of GBS and the vaccine against influenza A (H1N1) received by the patient. This is the first published case for the 2009 influenza pandemic in children. CONCLUSIONS While recent studies have found inconclusive results on the association between influenza vaccine and GBS, all suspected cases should be published for further evaluation.
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Affiliation(s)
- Marie-Eve Tremblay
- Pharmacy Department, Centre Hospitalier Sainte Justine, Montréal, Québec, Canada
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Lin TM, Lee SS, Lin RT, Lai CS, Lin SD. Guillain–Barré syndrome following facial bone fracture. J Plast Reconstr Aesthet Surg 2006; 59:543-6. [PMID: 16631562 DOI: 10.1016/j.bjps.2005.10.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2005] [Accepted: 10/19/2005] [Indexed: 11/19/2022]
Abstract
Guillain-Barré syndrome (GBS) is an inflammatory disorder of the peripheral nerves and nerve roots characterised by lymphocytes and macrophage infiltration and myelin destruction. Two-thirds of cases of GBS emerge from viral or bacterial infection. GBS following facial bone fracture is rare. This article discusses a case of classical GBS following facial bone fracture and its correlative mechanism. The association of GBS with head injury per se is not well recognised. This case highlights the possibility of GBS following facial bone fracture and indicates that medical staff should be alerted to the association.
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Affiliation(s)
- Tsai-Ming Lin
- Department of Plastic Surgery, Kaohsiung Medical University Hospital, 100 Tzyou 1st Road, Kaohsiung 80708, Taiwan, ROC.
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Labovitz AE, Mangurten HH. Guillain-Barré syndrome presenting with urinary retention and hypertension. Clin Pediatr (Phila) 2004; 43:659-61. [PMID: 15378155 DOI: 10.1177/000992280404300713] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Alexandra E Labovitz
- Department of Pediatrics, Advocate Lutheran General Children's Hospital, Park Ridge, Illinois 60068, USA
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Abstract
Miller Fisher syndrome is characterized by a triad of ataxia, ophthalmoplegia, and reduced or absent tendon reflexes, with minimal if any limb weakness. Anti-GQ1b immunoglobulin G antibodies are present in high titers in most patients. Presented is a two-year-old female with Miller Fisher syndrome whose blood serum was negative for anti-GQ1b immunoglobulin G antibodies.
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Affiliation(s)
- Hüseyin Tan
- University of Atatürk, School of Medicine, Erzurum, Turkey
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Shanbag P, Amirtharaj C, Pathak A. Intravenous immunoglobulins in severe Guillian-Barre syndrome in childhood. Indian J Pediatr 2003; 70:541-3. [PMID: 12940374 DOI: 10.1007/bf02723152] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This is a retrospective analysis of 25 children with severe Guillain-Barre syndrome admitted to our PICU. METHOD All children were treated with intravenous immunoglobulins (IVIG) in a dose of 2 g/kg body weight over 2-5 days in addition to supportive and respiratory care. Seventeen children were elective admissions to the PICU whereas 8 children were transferred from other hospitals in a critical condition. Five of 8 of the late referrals died as compared to none of the elective admissions. RESULT All 8 of the late referrals required mechanical ventilation as against 3 of the 17 elective admissions. Mean duration of PICU stay in the late referrals was 27 days as compared to 15 days in the elective admissions. CONCLUSION The authors concur with previously published reports, that early use of IVIG could reduce the mortality and the need for intubation and mechanical ventilation.
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Affiliation(s)
- Preeti Shanbag
- Department of Pediatrics, Lokmanya Tilak Municipal Medical College & General Hospital, Sion, Mumbai, India.
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Dias-Tosta E, Kückelhaus CS. Guillain Barré syndrome in a population less than 15 years old in Brazil. ARQUIVOS DE NEURO-PSIQUIATRIA 2002; 60:367-73. [PMID: 12131933 DOI: 10.1590/s0004-282x2002000300005] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
To know the impact of the Guillain Barré syndrome (GBS) in the population less than 15 years old, after the eradication of poliomyelitis. Data bank from the program of epidemiological surveillance of acute flaccid palsies (AFP) from the Fundação Nacional de Saúde were analyzed between 1990-1996. From 3619 notifications of AFP there were 1678 GBS. GBS yearly incidence rates is 0.39-0.63 cases/100,000. No consistent seasonal variation existed or relationship to vaccines. Weakness at inclusion were, moderate 52.1%, severe in 47.9%, sixty days after 57.1% normal, 7.4% mild, 15.7% moderate, 10.4% with severe deficits, death in 5.4%. 67 (4.0%) cases unknown. Death rates varies from 2.8% in southeast to 7.9% in the northeast. GBS was the most frequent cause of AFP. In spite of the severity of this disease being similar in the different regions, the outcome varies according to origin of the cases, possibly reflecting the economical conditions in those places.
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Affiliation(s)
- Elza Dias-Tosta
- Neurology Unit, Hospital de Base do Distrito Federal, Brasilia, DF, Brazil
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Mewasingh LD, Sékhara T, Dachy B, Djeunang MC, Dan B. Benign intracranial hypertension: atypical presentation of Miller Fisher syndrome? Pediatr Neurol 2002; 26:228-30. [PMID: 11955933 DOI: 10.1016/s0887-8994(01)00362-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Acute ocular paresis, nausea, vomiting, and headaches associated with high intracranial pressure without obvious intracranial pathology are typical features of benign intracranial hypertension. We describe two young children whose presentation, initially suggestive of idiopathic or benign intracranial hypertension, evolved to comprise ophthalmoplegia, ataxia, and areflexia. This triad characterizes Miller Fisher syndrome, a clinical variant of Guillain-Barré syndrome that occurs rarely among children. In both patients, this diagnosis was supported by the clinical course and neurophysiologic findings. Plasma serology was positive for Campylobacter jejuni and anti-GQ1b antibodies in one patient and for antimyelin antibodies in the other. This report of two children with Miller Fisher syndrome presenting with intracranial hypertension adds to the findings for a similar patient treated previously, which raises the question concerning the possible role or contribution of benign intracranial hypertension in Miller Fisher syndrome.
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Affiliation(s)
- Leena D Mewasingh
- Department of Neurology, Hôpital Universitaire des Enfants Reine Fabiola, 1020, Brussels, Belgium
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Abstract
Guillian Barré Syndrome (GBS) is an acquired disease of the peripheral nerves that is characterized clinically by rapidly progressing paralysis, areflexia, and albumino-cytological dissociation. It affects both genders, involves people of all ages, is reported worldwide, and in the post-polio era, it is the most common cause of an acute generalized paralysis. The clinical features are distinct and a history and an examination generally lead to a high suspicion of the diagnosis that can then be confirmed by supportive laboratory tests and electrodiagnostic studies. This review discusses the recent advances in understanding of the different variants of GBS such as acute inflammatory demyelinating polyneuropathy (AIDP), acute motor axonal neuropathy (AMAN), acute motor sensory axonal neuropathy (AMSAN), and the Fisher syndrome. The clinical, electrodiagnostic criteria, immunopathogenesis, and management of GBS and its variants are discussed.
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Affiliation(s)
- V V Vedanarayanan
- Department of Neurology, University of Mississippi School of Medicine, Jackson, USA
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Singhi SC, Jayshree M, Singhi P, Banerjee S, Prabhakar S. Intravenous immunoglobulin in very severe childhood Guillain-Barré syndrome. ANNALS OF TROPICAL PAEDIATRICS 1999; 19:167-74. [PMID: 10690257 DOI: 10.1080/02724939992491] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
To evaluate intravenous immunoglobulin (IVIG) therapy in children with very severe Guilain-Barré syndrome (GBS) with reference to the need for respiratory support, ICU stay and long-term outcome, we studied 33 children with very severe GBS and quadriparesis and/or respiratory muscle weakness admitted to the Pediatric Intensive Care Unit (PICU) of PGIMER, Chandigarh. Cases (n = 22, IVIG group) were enrolled prospectively, and controls (n = 11), similar to cases in age and severity of illness, retrospectively. All children received similar supportive and respiratory care. In addition, cases were given IVIG (Sandoglobulin, Sandoz) 0.4 g/kg bodyweight per day for 5 days. The mean age, duration of symptoms prior to admission and severity of illness in the two groups were similar. In the IVIG group, onset of recovery of muscle power was significantly earlier (day 14.8 (6.8) of illness vs day 20.9 (8.6), p < 0.05) and the length of PICU stay significantly shorter (20.5 (13.0) days vs 50.5 (33.3) days, p < 0.01). Sixteen (72.7%) children in the IVIG group had improved by at least one functional grade after 1 month and 15 (68%) were walking independently after 3 months compared with two (18%) and four (36%) controls, respectively (p < 0.05). The number of children who needed endotracheal intubation and mechanical ventilation and the duration of mechanical ventilation was significantly less in the IVIG-treated group. We conclude that in very severe GBS in children IVIG therapy improves outcome to a remarkable extent, reduces the need for intubation and mechanical ventilation, shortens the length of stay in ICU, and promotes ambulation sooner.
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Affiliation(s)
- S C Singhi
- Pediatric Intensive Care Unit, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
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Ismail EA, Shabani IS, Badawi M, Sanaa H, Madi S, Al-Tawari A, Nadi H, Zaki M, Al-saleh Q. An epidemiologic, clinical, and therapeutic study of childhood Guillain-Barré syndrome in Kuwait: is it related to the oral polio vaccine? J Child Neurol 1998; 13:488-92. [PMID: 9796754 DOI: 10.1177/088307389801301004] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We studied Guillain-Barré syndrome, affecting children 12 years old or less, throughout Kuwait, in the period between January 1, 1992, and March 31, 1997. Nineteen children had the diagnostic criteria of Guillain-Barré syndrome, with an overall annual incidence rate of 0.95/100,000 population at risk. Female patients outnumbered male patients with a sex ratio of 1.4:1. There was a clustering of cases in winter and spring and in the year 1996. The disease symptoms were relatively severe in our patients because only 16% (3 of 19) of them were able to walk at the height of their illness, whereas the rest were bed or chair bound or needed assisted ventilation. Two patients had the electrodiagnostic features of axonal neuropathy and both had residual deficits on follow-up, whereas the rest recovered fully. All the patients received intravenous immunoglobulin. The mean time to walk unaided was 23.5 days (range, 2-84 days) after intravenous immunoglobulin and excluding the two patients with axonal neuropathy, and full recovery was achieved in a mean time of 103 days (range, 30-300 days). Contrary to previous studies, we found no correlation between oral polio vaccine administration and Guillain-Barré syndrome in 2 successive years (1995 and 1996) during a nationwide campaign targeting children less than 5 years old.
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Affiliation(s)
- E A Ismail
- Department of Pediatrics, Farwaniya Hospital, Kuwait
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Terryberry JW, Shoenfeld Y, Peter JB. Clinical utility of autoantibodies in Guillain-Barre syndrome and its variants. Clin Rev Allergy Immunol 1998; 16:265-73. [PMID: 9773253 DOI: 10.1007/bf02737636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- J W Terryberry
- Specialty Laboratories, Inc., Neurology Group, Santa Monica, CA 90404, USA.
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