ABSTRACT
Guillain Barre syndrome [GBS] is an acute polyneuropathy with a relatively symmetrical weakness and a wide range of severity. It is a heterogeneous disorder which encompasses clinical and electrophysiological subtypes. Variability in the spectrum may be the result of different pathogenic mechanisms. Pure motor GB is one of these variants. If is an acute motor neuropathy with motor weakness without paranesthesia or sensory loss. We studied 9 patients with pure motor GB out of 40 patients with GB to assess the distinctive clinical, electrophysiological, and laboratory findings in this variant in Egyptian children. The results showed that pure motor GB was detected in 22.5% of GB patients during the period from April 2001 till the end of October 2002. The clinical course was preceded by illness during the 4 weeks prior to onset of GB in all patients with pure motor GB [100%] compared with 83.8% in the other GB patients. The cranial nerves were less frequently involved in pure motor GB [11.1%] than in other group [45.2%]. The descending pattern was observed in 33.3% patients with pure motor GB, compared with only 3.2% in other GB patients. However, the mean duration of clinical course until nadir of weakness was not statistically different between the two groups as well as the mean duration of improvement [P: 0.786, P: 0.113 respectively]. As regards the electrophysiological examination, 66.7% of acute motor axonal neuropathy [4 out of 6] had pure motor GB which was statistically significant [X[2]7.897, P: 0.005]. Campylobacter infection was detected in 4 patients of pure motor GB [44.4%] compared with only [12.9%] in other patients [P: 0.05] and Odd's ratio for risk estimate was 5.4 which was statistically significant
Conclusion: pure motor GB in Egyptian children has distinctive clinical, electrophysiological pattern. Ifs association with Campylobacter jejuni infection may explain the increased incidence of this variant in Egyptian children
ABSTRACT
Guillain-Barre syndrome [GBS] has become the most common cause of acute flaccid paralysis with virtual elimination of poliomyelitis. It has become apparent that the clinical spectrum of GBS comprises a group of pathological entities, each with distinctive features. The present study was conducted on 40 GBS children who were admitted to Alexandria University Children's Hospital from the start of April 2001 till the end of October 2002. The study finally concluded that: 1. Abnormalities of nerve conduction were the most sensitive and specific finding in GBS. 2. The electrophysiological type which was recorded in majority of the studied cases was acute inflammatory demy elina ting polyradiculo-neuropathy [AIDP], 30 cases [75%]. 3. The most reliable indicators for poor prognosis were respiratory muscle paralysis with the need for ventilation and/or electro diagnostic evidence of markedly reduced amplitude of motor action potentials of less than 20% of the lower limit of normal. 4. General supportive measures still remain important in the management. 5. Specific immunotherapy like I. V. immunoglobulin was found to be effective, particularly if started early within 2 weeks of onset of symptoms. 6. GBS has a good prognosis and mortality rate was about 11% which is similar to that in other studies