Guillain-Barre syndrome in childhood. A retrospective study of thirty-one cases

Guillain-Barre syndrome is characterized by ascending, flaccid, bilateral, symmetric paralysis that usually occurs in the wake of a viral or less often a bacterial infection, Patients and methods: the 31 children who were admitted to the Timone Teaching Hospital between 1983 and 1944 with a diagnosis of Guillain-Barre syndrome were studied retrospectively, Results: areflexic muscle weakness was almost universally present. Prodromal pain of various types was noted in 28 cases. Fourteen patients had involvement of cranial nerves, most often the IXth pair. A lumbar puncture was done in every case, and cerebrospinal fluid examination showed high protein levels with low cell counts in 22 cases; protein levels were higher in those patients with more severe disease, Immunoglobulin therapy was used in 19 cases, Six patients with mild manifestations received only supportive therapy, Seven patients with severe disease were admitted to an intensive care unit, but only one required ventilatory assistance. Mean time to recovery was 38 days. Thirty patients achieved a full recovery, and one had Prominent inaugural sensory signs should not lead the diagnosis astray, The outcome is usually favorable, although intensive care unit therapy and/or ventilatory assistance are sometimes needed in patients with cranial nerve involvement, and some patients are left with severe residual neurologic loss. Guillain-Barre syndrome is a pediatric emergency that requires a prompt diagnosis and immediate therapy based on clinical findings. Controlled studies of plasmapheresis or immunoglobulin therapy are not yet available in children, although both methods have been proved effective in adults.