ICNC Abstracts, ICNC 2018

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Guillain-Barré syndrome in a pediatric tertiary center (last five years)
Mafalda Sampaio, Cristina Garrido, Ruben Rocha, Marcio Cardoso, Ana Paula Sousa, Teresa Temudo, Sónia Figueiroa, Ines Carrilho, Manuela Santos

Last modified: 2018-09-09

Abstract


Background:

Guillain-Barré syndrome (GBS) is the most frequent cause of acute polyneuropathy. The diagnosis is based upon clinical presentation and, early in its course, the diagnostic workup may be normal.

Objectives and Methods:

Retrospective study of patients admitted with GBS, between 2013 and 2017.

Results:

Eleven patients were identified with a median age of 10.5 years at diagnosis. In the 3 weeks prior to symptoms onset, 6 patients presented a respiratory infection and 1 gastroenteritis.

Diagnosis was established on average 10 days after onset of symptoms (1-21). All six patients that underwent lumbar puncture one week after clinical onset had albuminocitological dissociation. None of cases that underwent earlier, showed dissociation. All except one had eletrophysiologic abnormalities. Spinal cord magnetic resonance imaging was performed in 5/11 patients and 4 exams showed alterations. Antiganglioside antibodies were found in 2 patients.

Ten patients were treated with intravenous immune globulin.Two patients require mechanical ventilation.

All patients achieved unaided walking, within a median of 8 weeks after discharge.

 

Comments:

The percentage of patients with a history of previous infections was similar to the current literature.

Delayed diagnosis seems to be related to parents’ inability to recognize first symptoms and a low index of suspicion in first attendance care.

None of the patients with symptoms lasting less than 1 week displayed albuminocitological dissociation. We highlight the importance of initial assessment and early treatment based on clinical diagnosis.

Although, most patients accomplished unaided walking within 6 months, prognosis of GBS is still associated with a significant morbility.


Keywords


Guillan-Barré, immune neuropathy

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