Konuşkan Bahadır, Okuyaz Çetin, Taşdelen Bahar, Kurul Semra Hiz, Anlar Banu
Department of Pediatric Neurology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Department of Pediatric Neurology, Mersin University Faculty of Medicine, Mersin, Turkey.
Noro Psikiyatr Ars. 2018 Jun 5;55(3):199-204. doi: 10.5152/npa.2017.16996. eCollection 2018 Sep.
We assessed the clinical, epidemiologic, electrophysiological and prognostic characteristics of childhood Guillain-Barré Syndrome admitted to 13 pediatric neurology centers in Turkey.
Using a standard data recording form age, sex, duration of symptoms, distribution of weakness at onset, cranial nerve involvement, cerebrospinal fluid findings, electrophysiological findings, duration of hospitalization, requirement of ventilation, treatment and clinical evaluation scale at onset, discharge and 1, 3, 6, and 12 months after discharge were recorded.
Among the 236 children with a median age of 6.8 years there was a male to female ratio of 1.3. Based on the electrophysiological features; 84 patients were classified as acute inflammatory demyelinating polyrediculoneuropathy (AIDP), 61 as acute motor axonal neuropathy (AMAN), 21 as acute motor-sensory axonal neuropathy (AMSAN). The incidence of cranial nerve involvement was 16%, and was related to lower clinical scores at discharge and 6 months after discharge. Clinical scale scores between axonal and demyelinating subgroups did not show statistically significant difference except for admission (p<0.05).
Electrophysiological subtypes are not important in prognosis in our series. However, duration of weakness, duration of hospitalization and ventilation requirement can affect prognosis negatively.
我们评估了土耳其13家儿科神经科中心收治的儿童吉兰-巴雷综合征的临床、流行病学、电生理及预后特征。
使用标准数据记录表格记录年龄、性别、症状持续时间、起病时肌无力分布、颅神经受累情况、脑脊液检查结果、电生理检查结果、住院时间、通气需求、治疗情况以及起病时、出院时、出院后1个月、3个月、6个月和12个月的临床评估量表评分。
在236名年龄中位数为6.8岁的儿童中,男女比例为1.3。根据电生理特征,84例患者被分类为急性炎症性脱髓鞘性多发性神经根神经病(AIDP),61例为急性运动轴索性神经病(AMAN),21例为急性运动感觉轴索性神经病(AMSAN)。颅神经受累发生率为16%,且与出院时及出院后6个月较低的临床评分相关。除入院时外,轴索性和脱髓鞘性亚组之间的临床量表评分差异无统计学意义(p<0.05)。
在我们的研究系列中,电生理亚型对预后并不重要。然而,肌无力持续时间、住院时间和通气需求可能对预后产生负面影响。