Long-term outcome in children with Guillain-Barré syndrome.
OBJECTIVE
To determine the long-term sequelae and early predictors of sequelae for children with Guillain-Barré syndrome (GBS) after the introduction of intravenous gammaglobulin (IVIG). Study design A cross-sectional case series of children with GBS, at least 2 years after recovery, was performed. Manual muscle strength testing was done on 34 muscle groups. The functional independence measure was used to assess function. A chart review was completed, identifying acute factors that may predict long-term sequelae.


RESULTS
Forty-seven children with GBS were identified, of whom 30 received IVIG. Persisting long-term muscle weakness with at least one muscle group at a grade 6 level (muscle moves the joint against gravity but only minimal resistance to an applied force) was found in 23% of cases. Each patient had a perfect score on the functional independence measure. Long-term muscle weakness was predicted by young age (P =.03) and a rapid progression to maximal weakness (P =.03).


CONCLUSIONS
Despite the introduction of IVIG, 23% of children with GBS had evidence of long-term mild muscle weakness, with minimal impact on function. Young age and a rapid progression during the acute GBS period predicted long-term sequelae.
Vajsar
Jiri
J
Division of Neurology, Department of Pediatrics, Population Health Sciences, Ontario, Canada. jiri.vajsar@sickkids.ca
Fehlings
Darcy
D
Stephens
Derek
D
D000203:Activities of Daily Living; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D020275:Guillain-Barre Syndrome / Q000150:complications* / Q000628:therapy; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D008297:Male; D009119:Muscle Contraction; D018908:Muscle Weakness / Q000175:diagnosis / Q000209:etiology; D011379:Prognosis; D012307:Risk Factors
D016756:Immunoglobulins, Intravenous