Electrophysiologic Subtypes and Prognosis of Childhood Guillain-Barre Syndrome

Jeong, Young Ho; Lee, Eun Hye; Jeong, Min Hee; Ko, Tae Sung

Abstract

PURPOSE
Guillain-Barre Syndrome(GBS) is an inflammatory polyneuropathy characterized by progressive, symmetric weakness and areflexia. GBS is currently subdivided into AIDP(acute inflammatory demyelinating polyneuropathy), AMAN(acute motor axonal neuropathy), AMSAN(acute motor sensory axonal neuropathy), and other subtypes based on results from electrophysiological studies. Our study is intended to evaluate the clinical characteristics and prognosis of pediatric GBS and its subtypes.
METHODS
From January 1999 to June 2009, We retrospectively reviewed of fifty patients with GBS the clinical manifestations and laboratory findings at the Asan Medical Center. Forty-six patients were classified into subtypes based on the results from electrophysiological studies.
RESULTS
Forty-five(90.0%) patients exhibited lower limb weakness, 26(56.5%) patients had both lower and upper limb weakness, and eleven(23.9%) had sensory nerve involvement seen at their initial presentation. Of the 46 patients, 22(47.8%) had AIDP, seven had AMAN(15.2%), 12 were unclassified(26.0%), and five had normal nerve conduction studies. The AIDP and AMAN groups were not significantly different in age, gender, and clinical characteristics. Five patients(22.7%) in the AIDP group and one patient(14.3%) in the AMAN group had respiratory failure, which did not differ significantly according to their group. However, the AMAN group needed a significantly longer period of time on average to walk independently than the AIDP group(99.2+/-97.0 days vs. 39.1+/-29.7 days, P=0.022).
CONCLUSION
Our electrophysiological data show that 15.2% of the pediatric patients with GBS had the AMAN-type disease, and these children underwent longer periods of recovery than children in the AIDP group.