Outcome in childhood guillain-barré syndrome.

To assess the outcome of children diagnosed with Guillain-Barré syndrome (GBS), followed up for a median duration of 25 months. Methods. Tertiary center, prospective follow up of children with GBS enrolled from Dec 2003 through Sep 2006. Functional recovery was determined at 12 months and later using Hughes scale (0-6). Clinical, electrophysiological variables were compared between the good outcome (grade 0/1) and bad outcome groups (died or functional grade >1). Results. Among 52 children with a median age of five yr there was male preponderance (75.4%). Mortality during acute phase was 11.5% (6/52). Among the survivors long term data was obtainable in 40 of the 46 children. At one year follow up 87.5% children had fully recovered or had minimal symptoms, beyond one year this rose to 95%. Only 2 among 40 had significant symptoms at last follow up (1 grade-2 and 1 grade-3). Factors significantly associated with poor outcome were: need for artificial ventilation, inexitable nerves on nerve conduction testing and delayed independent walking. Conclusion. Children needing ventilation have the worst short-term prognosis. However, irrespective of severity during acute phase, good long-term recovery can be expected in most children.

Clinical presentations and complcations of Guilain barre syndrome in Children Welfare Teaching hospital

To study the clinical presentations and complications in patients with Guillain Barre syndrome [GBS]. A retrospective study was done on 70 patients with GBS from different parts of Iraq, who were admitted to children Welfare Teaching Hospital in Medical City, Baghdad in the period between January 2002 to December 2006. Of 70 patients with GBS, 40 [57.14%] were males and 30 [42.86%] were females, with a male to female ratio of 1.33:1. Antecedent events were found in 44 patients [62.86%], wherease 26 patients [37.14%] had no history of antecedent events. There is no specific pattern of motor weakness involvement and all cases show symmetrical muscle weakness. Bulbar nerves involvement is the commonest cranial nerve involvements. Autonomic nerves and respiratory muscles involvement are the main cause of death in GBS

Epidemiology and characteristics of Guillain-Barre syndrome in the northwest of Iran

Little is known about the incidence of Guillain-Barre syndrome [GBS] in Iran. We determined the incidence and evaluated prognostic factors for GBS in a prospective, population-based study. We evaluated and followed all patients with a diagnosis of GBS admitted to three referral neurology centers in East Azerbaijan province over a 1-year period [2003]. Clinical and electrophysiological characteristics of cases were reviewed and analyzed. A total of 76 patients were found, corresponding to a crude annual incidence rate of 2.11/100 000 population. Six patients [7.9%] died acutely within 21 days from the onset of the disease. Acute mortality was due to respiratory involvement, sepsis and acute autonomic system dysfunction. The persistence of disability after the acute phase was related to axonal involvement [OR=3.19, 95%CI, 1.65 to 6.16]. There was a significant correlation between a history of diarrhea and a further need for mechanical ventilation [P<0.05]. Mechanically ventilated patients had a low GBS disability score on discharge compared with patients not mechanically ventilated [P=0.05]. The incidence rates of GBS in our province is similar to that in other countries. Acute mortality in GBS was mostly due to poor respiratory care of patients and infective complications, but disability and probably late mortality were due to axonal nerve injury

Clinical presentation and outcome of patients presenting with guillain barre syndrome

To identify the clinical features and outcome of Guillain Barre syndrome [GBS] in patients presenting to general I. C. U. This descriptive study was carried out on patients with the clinical evidence of GBS admitted in the General Intensive Care Unit of Lady Reading Hospital Peshawar, from January to December 2005. All those patients having sensory loss or in whom only legs were affected were excluded from the study. Each patient had a detailed interview and underwent complete neurological and systemic examination. After the confirmation of diagnosis of GBS, the treatment was started accordingly. In this study 14 patients with GBS were treated. There were 13 [93%] male and 1 [07%] female. Ten [71.4%] were in the age range of 15-60 years. All [100%] patients presented with limb weakness. Numbness and paraesthesia was noted in 9 [64.28%] patients. Four [28.57%] patients presented with respiratory difficulty. Muscle weakness and absent reflexes were present in all patlents. Nine [64.1%] patients were offered conservative treatment and 4 [28.6%] patients were treated with assisted ventilation and 1 [07.1%] patient received lmmunoglobulins therapy. Four [28.6%] patients expired in ICU due to respiratory failure in spite of being on ventilator. One [07.1%] patient was taken to home by the attendant against medical advice. More males are affected than females. Limb weakness, respiratory muscles weakness and absent or diminished reflexes are the commonest clinlcal features. Hlgh mortality in this disease is associated with respiratory failure