ICNC Abstracts, ICNC 2018

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Spectrum of Guillian Barre syndrome in children – atypical features, types, prognostic indicators and relationship to zika virus.
Ishita Tewari, Chandrakanta Kumar, Ravindra Garg, Amita Jain, Rashmi Kumar

Last modified: 2018-09-09

Abstract


AIM: To study clinical features, types and prognostic indicators of Guillian Barre syndrome (GBS) at  a tertiary care public hospital in northern India.

 

METHODS: Consecutive children hospitalized with GBS were enrolled.  Clinical history, examination and investigations were charted. Factors on admission associated with need for ventilation  were analysed.  Zika virus DNA was looked for by real time PCR using Trioplex Taqman (CDC reagents) in serum and urine.

 

RESULTS:  31 children [mean age in months 74.0 (35.7); 61% boys] were enrolled.  Mean duration (SD) of illness was 5.25 (3.82) days.  28 (90.3%) had ascending paralysis. Bulbar involvement was seen in 12 (38.7%), extensor plantar reflexes  in 2 (6.4%), severe pain in 6 (19.3%), bladder involvement  in 7 (22.6%)  and hypertension in 8 (25.8%).  Nerve conduction studies done in 25 patients revealed  acute motor axonal neuropathy in 16 (64%) and acute motor sensory axonal neuropathy in  9 (36%). All fulfilled Brighton criteria for diagnosis.  Severity according to Hughes Disability Scale was  4 or 5 in 29 (93.5%).  Intravenous immunoglobulin was administered in  28 (90.3%).  Six patients required assisted  ventilation.  Factors associated with ventilation were higher age, change in voice, single breath count,  weakness in upper limbs, hypertension, higher neutrophil  but lower lymphocytes percentage in blood and  higher Hughes Disability Score on admission.  Only one patient died.  Zika virus DNA was not found in any case.

CONCLUSIONS: Need for ventilation can be predicted in GBS.  Zika virus infection is probably not associated with GBS here.

 

 

 


Keywords


Guillian Barre Syndrome, zika virus, prognostic indicators

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