Pediatric Guillain-Barré syndrome: Indicators for a severe course.
OBJECTIVE
This study aims to retrospectively evaluate pediatric Guillain-Barré syndrome cases in a tertiary center in Istanbul, Turkey.


METHODS
The data of 40 patients with Guillain-Barré syndrome who had been admitted to the Department of Pediatrics at the Istanbul University Medical Faculty between 2005 and 2011 were collected. Mann-Whitney U, Kruskal-Wallis, chi-square, and Fisher's exact tests were used for statistical analysis.


RESULTS
Mean patient age was 5.4 ± 3.0 years; 20 out of 40 patients (50%) were female and 20 (50%) were male. Preceding infection was detected in 32 cases (80%). Six patients had speech impairment. Out of eight patients with respiratory distress (20%), five required respiratory support (12.5%) of which three of them had speech impairment as well. According to nerve conduction studies, 21 patients (52.5%) had acute inflammatory demyelinating polyradiculoneuropathy, 14 (35%) had acute motor axonal neuropathy, and five (12.5%) had acute motor-sensory axonal neuropathy. Thirty-three patients (82.5%) received intravenous immunglobulin, 3 (7.5%) underwent plasmapheresis and 4 (10%) received both. Time until recovery (P = 0.022) and time until aided (P = 0.036) and unaided (P = 0.027) walking were longer in patients with acute gastrointestinal infection than in those with upper respiratory tract infection (P < 0.05). Time until response to treatment (P = 0.001), time until aided (P = 0.001) and unaided (P = 0.002) walking, and time until complete recovery (P = 0.002) were longer in acute motor axonal neuropathy cases as compared to acute inflammatory demyelinating polyradiculoneuropathy cases.


CONCLUSIONS
Recovery was longer with acute gastrointestinal infection and acute motor axonal neuropathy. Speech impairment could be a clinical clue for the need of mechanical ventilation.
Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Fatih, Istanbul, Turkey.
Muhammet Ali
MA
Varkal
Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Fatih, Istanbul, Turkey.
Tuğçe Aksu
TA
Uzunhan
Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Fatih, Istanbul, Turkey.
Nur
N
Aydınlı
Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Fatih, Istanbul, Turkey.
Barış
B
Ekici
Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Fatih, Istanbul, Turkey.
Mine
M
Çalışkan
Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Fatih, Istanbul, Turkey.
Meral
M
Özmen
Guillain-Barré syndrome; intravenous immunoglobulin; mechanical ventilation; plasmapheresis