660: RECURRENT GUILLAIN-BARRE SYNDROME: CLINICAL PROFILE AND OUTCOME OF CHILDREN FROM A NORTH INDIAN PICU

Abstract

Introduction: Guillian-Barre Syndrome (GBS) is an acute flaccid ascending paralysis, usually considered a monophasic illness. Recurrences do occur in an undefined group of patients. However, there is a dearth of literature on recurrent GBS, especially in the pediatric age group. We studied the subgroup of recurrent GBS in children and compared the clinical, neurological, treatment and outcomes of these children with non-recurrent GBS. We also compared different episodes of recurrent GBS. Methods: Patients’ case records were retrieved retrospectively from the electronic database and case record files. All children diagnosed with GBS admitted to PICU from 2010 to March 2022 were screened. Clinical profile, nerve conduction study, treatment and outcome details were recorded. Recurrent GBS cases, as defined by the National Institute of Neurological and Communicative Diseases and Strokes (NINCDS) criteria, were analyzed separately. The comparison was made between the first episode of recurrent GBS with non-recurrent GBS, and predictors of recurrence were identified. A comparison of course and outcome was also done between different episodes of GBS in recurrent cases. Results: 11(4.7%) out of 234 cases admitted to PICU between 2010 and March 2022 had recurrent GBS. Respiratory (p-0.015) and gastrointestinal illness (0.007) as preceding illnesses were predictors of recurrence. No difference was noted between the first episode of recurrent GBS and non-recurrent GBS. The first and second episodes of GBS in 11 recurrent cases were similar in course and outcome. Conclusions: Recurrent GBS is underreported but a known entity. Respiratory and gastrointestinal illness in first-episode predicted recurrence. We did not observe any difference between the 2 episodes of recurrent GBS. However, more data is required to find the features of recurrent GBS so that limited PICU resources can be used judiciously and intervention planned accordingly.