Muhammad Yasin Alvi, Tayaba Khawar, Muhammad Abbas, Saadia Saeed, Muhammad Ali Khan.
Clinical spectrum of Guillain-barre syndrome (GBS) in children.
Pak J Med Health Sci Jan ;4(4):555-8.

Objectives: To evaluate the clinical course of GBS in children. Materials and methods: The study was conducted at Department of Pediatrics, the Children Hospital and Services Hospital, Lahore from 2001 – 2008 including 134 children up to the age of 15 years admitted with AFP. Routine investigations were done in all patients while CSF examination, nerve conduction studies (NCS) and electromyography (EMG) were done in most of the patients depending upon facilities available. Treatment modalities including supportive, intravenous immunoglobulin (IVIG) and plasmapheresis were used depending upon indications and facilities available. Results: Out of 134 patients with AFP, 121 (90.3%) were diagnosed as GBS. Mean age of children with GBS was 6.2 years with a male to female ratio of 1.6:1. History of preceding illness was present in 67.8%, sensory symptoms in 71.9% and autonomic dysfunction in 61.1% patients. Classical GBS (symmetrical ascending paralysis) was present in 92.6% patients, 2.5% patients had descending paralysis, 4.1% had relapsing variety and one patient had chronic inflammatory demyelinating polyneuropathy. On electrophysiological studies, 33.3% patients had demyelinating variety, 44% had demyelinating with axonal involvement and 22.5% patients were labeled as unclassified. 53 (43.8%) patients required mechanical ventilation. 35.6% patients with axonal variety 23.5% patients with demyelinating variety required mechanical ventilation. 56 patients were treated with IVIG and out of these 36 patients improved, and 9 patients showed no improvement and plasmapheresis was done in these patients. Conclusion:GBS is the commonest cause of AFP. GBS with axonal involvement is more severe as compared to demyelinating type and IVIG is an effective treatment modality for childhood GBS.

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