Management of children with Guillain-Barre syndrome

Guillain-Barré syndrome is the most common cause of acute flaccid paralysis in childhood in countries with established immunisation programmes. The diagnosis is generally relatively straightforward for experienced clinicians, but occasionally can be a challenge, even to the most experienced. A better understanding of the pathogenesis of the disease has led to developments in the treatment options over the last two decades. This, along with a better multidisciplinary approach to management, concentrating on an early anticipation and prevention of the complications, has improved outcome in the disease. Further randomised controlled trials are still needed in childhood GBS but are in practical terms more difficult to achieve. However, several small series and case reports suggest that both plasmapheresis and human immunoglobulin are helpful in reducing morbidity and speeding recovery in children with GBS.