Clinical presentation and prognosis of childhood Guillain-Barré syndrome.
OBJECTIVE
Guillain-Barré syndrome (GBS) is an acute inflammatory polyneuropathy commonly characterised by rapidly progressive, symmetric weakness and areflexia. This study is to assess the clinical characteristics of paediatric GBS, as well as its long-term functional prognosis.


METHODS
We retrospectively assessed the clinical manifestations, results of electrodiagnostic tests, functional status and prognosis of 56 children diagnosed with GBS. Based on clinical and electrophysiological findings, the patients were classified as having acute inflammatory demyelinating polyradiculoneuropathy ([AIDP]n = 34), acute motor axonal neuropathy ([AMAN]n = 14), acute motor and sensory axonal neuropathy (n = 1) and Miller Fisher syndrome ([MFS]n = 7).


RESULTS
Upper respiratory infection was the most frequent preceding event, and limb weakness was the most frequent symptom at GBS onset. There was no significant difference in the mean time from the onset of illness to nadir between any of these groups. Both the AIDP and AMAN groups showed significantly poorer functional status, measured by the Hughes scale, than the MFS group. Two years after nadir, however, the three groups did not differ significantly. Functional status at nadir, as estimated by the Hughes scale, is a more important factor than electrophysiological types in predicting long-term outcome.


CONCLUSIONS
The most common symptom at onset in paediatric GBS was limb weakness. Functional status at nadir in AMAN was not significantly different from that of AIDP, and both types achieved good functional outcome for ambulation after 2 years. Functional status at nadir was more important than the electrophysiological type in predicting long-term outcomes.
Department of Physical Medicine and Rehabilitation, Wooridul Spine Hospital, Seoul, Korea.
Jung Hwan
JH
Lee
In Young
IY
Sung
Il Sun
IS
Rew
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D020275:Guillain-Barre Syndrome / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D008297:Male; D018908:Muscle Weakness / Q000209:etiology; D011379:Prognosis; D012189:Retrospective Studies