Clinical features and outcome of Guillain-Barré syndrome in children

Jafar Nasiri, mohammadreza ghazzavi, omid yaghini, mohammadreza chaldavi




Background: Considering the fact that there are no reports about the clinical presentations and outcome of Guillain-Barré syndrome (GBS) in our region, we aimed to report some mentioned findings in children diagnosed with GBS in Isfahan, Iran. Materials and Methods: In this retrospective study, pediatric patients diagnosed with GBS were enrolled.The following information were extracted from the medical files of patients; age, gender, early signs and symptoms of GBS, neurological features, sensory and motor and autonomic involvements, sphincter dysfunction, bulbar muscle involvement, respiratory failure, cranial nerve paralysis, delay time from onset to definite diagnosis and management of GBS and the outcome. Results: During this study, 57 children with GBS aged 1-13 years were evaluated. Frequency of GBS was significantly higher in boys than in girls (38.6% vs. 61.4%, P=0.01, OR=0.39). The most common clinical presentations were distal lower limb weakness (92.11%), reduced deep tendon reflex (DTR ) (82.46%) and neuropathic pain (75.44%). 92.9% of patients had complete recovery. Conclusion: The findings of this study indicated that distal lower limb weakness, reduced deep tendon reflex and neuropathic pain are the main clinical presentation in children with GBS but in some patients DTR may be normal or even exaggerated in early stage of disease. This finding suggests that revising the diagnostic criteria for GBS may be necessary. Most of our patients had complete recovery. The only death was due to autonomic involvement.


Guillain-Barré , children, outcome, clinical presentation

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Yuki N, Hartung HP. Guillain-Barré syndrome. N Engl J Med. 2012;366(24):2294-304.

Sladky JT. Guillain-Barré syndrome in children. J Child Neurol. 2004;19(3):191-200.

Sejvar JJ, Baughman AL, Wise M, Morgan OW. Population incidence of Guillain-Barré syndrome: a systematic review and meta-analysis.Neuroepidemiology. 2011;36(2):123-33.

Barzegar M, Dastgiri S, Karegarmaher MH, Varshochiani A. Epidemiology of

childhood Guillan-Barre syndrome in the north west of Iran. BMC Neurol. 2007 ;7:22.

Barzegar M. Childhood Guillain-Barre Syndrome. Iran J Child Neurology 2009:3(1).7-14.

Ansar V, Valadi N. Guillain-Barré syndrome. Prim Care. 2015 ;42(2):189-93.

Dash S, Pai AR, Kamath U, Rao P. Pathophysiology and diagnosis of Guillain-Barré syndrome - challenges and needs. Int J Neurosci. 2015 ;125(4):235-40.

Fujimura H. The Guillain-Barré syndrome. Handb Clin Neurol. 2013;115:383-402.

Arcila-Londono X, Lewis RA. Guillain-Barré syndrome. Semin Neurol. 2012 ;32(3):179-86.

Korinthenberg R, Schessl J, Kirschner J. Clinical presentation and course of childhood Guillain-Barré syndrome: a prospective multicentre study.Neuropediatrics. 2007;38(1):10-7.

Pier DB, Hallbergson A, Peters JM. Guillain-Barré syndrome in a child with pain: lessons learned from a late diagnosis. Acta Paediatr. 2010;99(10):1589-91.

Roodbol J, de Wit MC, Walgaard C, de Hoog M, Catsman-Berrevoets CE, Jacobs BC.Recognizing Guillain-Barre syndrome in preschool children. Neurology. 2011;76(9):807-10.

McGrogan A, Madle GC, Seaman HE, de Vries CS: The epidemiology of Guillain-Barre syndrome worldwide. A systematic literature review.Neuroepidemiology 2009, 32(2):150–163.

Asbury AK, Cornblath DR. Assessment of Current Diagnostic Criteria for Guillain-Barre syndrome. Ann Neurol. 1990; 27 Suppl:S21-4.

Koul R, Al-Futaisi A, Chacko A et al.. Clinical Characteristics of Childhood Guillain-Barré Syndrome. Oman Med J. 2008; 23(3): 158–61.

Molinero MR, Varson D, Holden KR, Sladky JT, Molina IB, Cleaves F. Epidemiology of childhood Guillian-Barre Syndrome as a Cause of Acute Flaccid Paralysis in Honduras: 1989-1999. J Child Neurol 2003; 18: 741-747.

Kumar M, Aroor S, Mundkur S, Kumar S. Guillain-barré syndrome: a clinical study of twenty children. J Clin Diagn Res. 2015 ;9(1):SC09-12.

Devos D, Magot A, Perrier-Boeswillwald J, Fayet G, Leclair-Visonneau L,Ollivier Y, Nguyen The Tich S, Pereon Y. Guillain-Barré syndrome during childhood: particular clinical and electrophysiological features. Muscle Nerve.2013;48(2):247-51.

Karimzadeh P, Bakhshande Bali MK, Nasehi MM, Taheri Otaghsara SM, Ghofrani M. Atypical Findings of Guillain-Barré Syndrome in Children. Iran J Child Neurol 2012;6(4):17-22.

Ashrafzadeh F, Ariamanesh A. Outcome of Guillain-Barre syndrome in children. Iran J Pediatr, 2005 :15(4):309-12.

Olive JM, Castill OC, Castro RG, Qaudros CA.Epidemiologic study of Guillian- Barre Syndrome in children less than 15 years of age in Latin America. J Infect Dis 1997; 175 (suppl1): 160- 164.

-Satoshi Kuwabaraa, Kazue Ogawaraa, Michiaki Kogab, Masahiro Moria, Takamichi Hattoria, Nobuhiro Yuki. Hyperreflexia in Guillain-Barré syndrome: relation with acute motor axonal neuropathy and anti-GM1 antibody. J Neurol Neurosurg Psychiatry 1999;67:180-184 doi:10.1136/jnnp.67.2.180

Yuki N, Kokubun N, Kuwabara S, Sekiguchi Y, Ito M, Odaka M, Hirata K, Notturno F, Uncini A.Guillain-Barré syndrome associated with normal or exaggerated tendon reflexes.

Paradise G. trpoli J,Galicchio S, Fejerman N. Epidemiol ogical,clinical,and electrodiagnostic finding in childhood Guillain-Barre syndrome : a reappraisal. Ann Neurol 1999; 46:701-705.

Lee JH, Sung IY, Rew IS. Clinical presentation and prognosis of childhood Guillain–Barre syndrome. J Paediatr Child Health 2008;44:449–454

Linden V, da Paz JA, Casella EB, Marques-Dias MJ. Guillain-Barré syndrome in children: clinic,laboratorial and epidemiologic study of 61 patients. Arq Neuropsiquiatr. 2010 ;68(1):12-7.

Jones HR. Childhood Guillain–Barr_e syndrome: clinical presentation,diagnosis, and therapy. J Child Neurol 1996;11:4–12.

Sri-udomkajorn S, Suwannachote S. Demographics, clinical features, outcome and prognostic factors of Guillain-Barre syndrome in Thai children. J Med Assoc Thai.2014;97 Suppl 6:S101-7.

Korinthenberg R, Schessl J, Kirschner J. Clinical presentation and course of childhood Guillain-Barré syndrome: a prospective multicentre study.Neuropediatrics. 2007 ;38(1):10-7.

Moore P, James O. Guillain–Barr e syndrome: incidence, management and outcome of major complications. Crit Care Med 1981;9:549–555



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