Pure motor guillain barre among Egyptian infants and children

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