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Pediatric Guillain-Barré syndrome. Experience in the Neuropediatrics Unit of a Portuguese hospital

J.P. Monteiro, S. Fonseca, J. Proença, P. Calhau, M. Braga, M.J. Fonseca [REV NEUROL 2006;42:144-149] PMID: 16475135 DOI: https://doi.org/10.33588/rn.4203.2004171

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Volumen 42 | Number 03 | Nº of views of the article 9.211 | Nº of PDF downloads 1.896 | Article publication date 01/02/2006

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ABSTRACT

INTRODUCTION Guillain-Barré syndrome (GBS) is an acute inflammatory ascending polyradiculoneuropathy. Autoimmune mechanisms play a role in the demyelinating process. Clinically, progressive symmetric loss of motor strength, arreflexia, sensitive and autonomic manifestations are observed. Albuminocytological dissociation and electrophysiological signs of demyelination are frequently found. It is the most common cause of acute flaccid paralysis in children.

PATIENTS AND METHODS Retrospective review of all children with GBS admitted to Garcia de Orta Hospital in a 10 year period (1994-2003).

RESULTS 17 children (18 months to 14 years) were admitted during this period. Respiratory or gastrointestinal prodrome was identified in 15 children, with positive serologic studies in six. The main clinical manifestations were disturbances of gait, progressive muscular weakness, sensitive manifestations (pain, paresthesias) and osteotendinous arreflexia. 13 children had albuminocytological dissociation and acute demyelinating neuropathy was identified in 12.64% of children were treated with immunoglobulins (2 g/kg). Clinical evolution was favourable in 16 cases, with a death secondary to autonomic dysfunction.

CONCLUSIONS Clinical presentation may be unspecific, particularly in young patients, with pain as a primary complaint, preceding muscular weakness and arreflexia. Increased cerebrospinal protein and abnormal electrodiagnostic studies may be absent in the early course of GBS. Immunoglobulin therapy was efficacious and well-tolerated. KeywordsChild Dysautonomia Guillain-Barré syndrome Immunoglobulin Polyradiculoneuropathy CategoriesNervios periféricos, unión neuromuscular y músculo Neuropediatría

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Pediatric Guillain-Barré syndrome. Experience in the Neuropediatrics Unit of a Portuguese hospital