Abstract
Objective: Recognizing the clinical presentation of Guillain–Barre syndrome in children. Design: Retrospective observational study. Setting: Pediatric wards and Paediatric Intensive Care Unit. Method: A medical record files of 52 patients of GBS, between the periods of March 2011 to February 2016 were recovered from Medical Record and Statistics Section of institute. Files were analyzed for demographic data, clinical features, co-morbid conditions, investigations, electrophysiological data, mode and result of treatment and data was analyzed. Result: In our series males are outnumber to female and most of the patients in age group 6-12 years, 48% were belongs to lower socioeconomic status. In 53.8% patients antecedents were present at the beginning of clinical picture and upper respiratory tract infection (28.84%) & diarrohea (19.23%) was noted with predominant occurrence in monsoon season (52%). Bilateral lower limb weakness was noted in all patients and in 61.9% patients were common complaint pain in lower limb. Cranial nerve involvement was evident in 28.85% and bulbar involvement was commonest followed by facial nerve. A 23.07% patients were presented with respiratory involvement, 9 of them (15.38%) were needed assisted ventilation. Dysautonomic sign/symptoms were present in 26.92% with 73.33% had demyelinating pattern of neuropathy and 9.6% mortality. Conclusion: The clinical characteristics of GBS in children are not consistent and differ from geographical area and racial diversity.
Highlights
Since poliomyelitis has been nearly been eliminated, the Guillain–Barry Syndrome (GBS) is currently the most frequent cause of acute flaccid paralysis worldwide and constitutes one of the serious emergency in neurology [1]
Barre and Strohl (1916) described a benign polyneuritis with albumin-cytological dissociation in the cerebrospinal fluid [4] and the first report regarding pathology of GBS was by Haymaker and Kernohan in 1949 who reported that edema of the nerve roots was an Manuscript received: 15th May 2016 Reviewed: 27th May 2016 Author Corrected; 11th June 2016 Accepted for Publication: 25th June 2016 important change in the early stages of the disease [5]
In North America and Europe, typical patients with GBS usually have the demyelinating variant termed acute inflammatory demyelinating polyneuropathy (AIDP) accounts for up to 90% of cases [10 ], whereas in China, Japan, Bangladesh and Mexico, the frequency of axonal Guillain-Barre syndrome ranges from 30-65% and the frequency of demyelinating GBS ranges from 22 to 46% [11,12]
Summary
Since poliomyelitis has been nearly been eliminated, the Guillain–Barry Syndrome (GBS) is currently the most frequent cause of acute flaccid paralysis worldwide and constitutes one of the serious emergency in neurology [1]. Other important landmarks are Landry’s report in 1859 about an acute, ascending, predominantly motor paralysis with respiratory failure, leading to death [2] and Osler’s (1892) description of afebrile polyneuritis [3]. Global annual incidence is reported to be 0.6-2.4 cases per lakh population per year [7, 8]. It increases in incidence with age and there is a small predominance of male [9].
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