A Retrospective Single-center Study of Presentation and Prognosis of Guillain-Barré Syndrome in Pediatric Patients

 Guillain-Barre syndrome (GBS) is a post-infectious immune-mediated peripheral neuropathy, progressing bilaterally and often symmetrically and affecting sensory and motor function. Most cases completely recover, but around 20% of cases may lead to complications, incomplete recovery, or even death.

 This study aims to assess the prognosis of GBS in pediatric patients and possible associated conditions regarding recovery or prognosis.

 We investigated 71 cases of GBS admitted to Mofid Pediatric Hospital from March 2014 to March 2017. Demographic, clinical, and laboratory data were retrospectively recorded and analyzed. Two follow-up visits were performed after 1 to 3 and 5 to 8 years from onset, according to the GBS Disability Scale, and recovery of motor function was assessed during patients’ visits to the clinic.

 We found 35 male and 36 female subjects with an average age of 6.17 ± 3.82 (range 0.9 up to 15 years old); cases were mostly presented with myalgia and weakness (78.9%) followed by headache, found in 5 patients (7%). Around 84.5% of patients had an upper respiratory infection as their antecedent infection. Fifteen cases of autonomic dysfunction were observed, and 15 patients had cranial nerve involvement. Most cases had the acute inflammatory demyelinating polyradiculoneuropathy (AIDP) form of GBS on electrophysiologic tests. Analysis showed only axonal involvement was significantly correlated with poor prognosis (P-value<0.05), and other variables were not significantly correlated.

 Compared to the current literature, we found fewer autonomic dysfunctions, cranial neuropathies, and a smaller percentage of AIDPs in our data. Altogether, the axonal form of GBS is reported as a predictor of an unfavorable prognosis in GBS patients.