Different subtypes of Guillane-Barré syndrome in children

Abstract

Guillan-Barre syndrome (GBS) is a debilitating illness with different subtypes depending on geographical area. In this study we review the GBS subtypes in Iranian children. One hundred and eight children below 15 yr entered the study during 7 yr (1998-2005), they were evaluated in 1 st (95 cases) and 2 nd wk (13 cases) diagnosed clinically, electrodiagnostically and their cerebrospinal fluid (CSF) were analyzed. Patients were divided into demyelinating and axonal forms. Data were analyzed by t test for continuous measures and the Fisher's exact test for categorical variables in SPSS 16. P less 0.05 was significant. The means age ± SD of affected patients are 4.8 ± 2.7 yr (minimum 1 yr, maximum 14.5 yr). CSF protein and pleocytosis were more common in 2 nd wk group (77 mg/dL in first week versus 63 mg/dL in second week); 2% (first week) and 30% CSF pleocytosis occurred (second week). Demyelinating form happens in 47% of patients, axonal 40% and combined form of axonal and de- myelinating form happened in 9%. Normal electrodiagnostic tests in spite of clinically confirmed GBS were observed in 4%. CSF protein was higher in demyelinating compared to axonal form (71 mg/dL and 54 mg/dL). There is no sex predilection for GBS affection (59 males, and 49 females). Peak incidence of GBS in children is below age of 5 yr (65%) ;axonal form of GBS (sensory and motor) make a considerable proportion of GBS in children (40%) with lower CSF protein compared to demye- linating type, but it is not statistically significant (P > 0.05).