Guillain-Barre syndrome in southern Chinese children: 32 year experience in Hong Kong

Background: The purpose of the present study was to investigate the clinical pattern of Guillain-Barre syndrome (GBS) in southern Chinese children in Hong Kong and to compare the clinical outcome of early versus delayed intervention with i.v. immunoglobulin (IVIg). Methods: A retrospective review of medical records of GBS patients admitted to two hospitals on Hong Kong Island during a 32 year period (1976-2008) was performed. Clinical outcome was compared for early versus late IVIg treatment, using a 7 day cut-off. This analysis was then repeated using a 10 day cut-off. Results: Of 34 children, 22 (65%) had preceding illness but no infective etiology could be identified. Nerve conduction was measured in 17 (50%): nine had demyelinating neuropathy, three had axonal neuropathy with demyelinating features, two had pure axonal neuropathy, and one was normal. In two patients with Miller-Fisher syndrome (MFS) the studies showed additional abnormal sensory conduction. Twenty-one received conservative treatment only. Ten (29%) received IVIg, two (6%) received plasmapheresis and three (9%) received corticosteroid. Thirty-one (91%) had complete recovery, two (6%) had long-term morbidity and one died of respiratory failure. Comparison of the early and late IVIg treatment groups for each cut-off showed no statistically significant difference in clinical outcome. A longer period of hospital stay and longer time to improve one disability grade, however, were noted for the late treatment group for both cut-offs. Conclusions: The clinical profile of GBS in southern Chinese children in Hong Kong is provided. There was no statistically significant difference between early versus delayed treatment with IVIg.