Parveen Asmat, Khan Sabeen Abid, Talat Sidra, Hussain Syeda Namayah Fatima
Pediatrics, Benazir Bhutto Hospital, Rawalpindi, PAK.
Pediatrics, Shifa College of Medicine, Shifa Tameer-E-Millat University, Islamabad, PAK.
Cureus. 2020 May 11;12(5):e8052. doi: 10.7759/cureus.8052.
Objective Guillain Barre syndrome (GBS) is an autoimmune-mediated, acute, symmetrical, flaccid paralysis. Guillain Barre syndrome has different electrophysiological types that carry prognostic significance and tend to differ between adults and children. This study aims to compare the clinical outcome of Guillain Barre syndrome in Pakistani children based on their electrophysiological types to help in understanding and predicting the prognosis. Study design Observational comparative study Place & duration The pediatric department, Shifa International Hospital, Islamabad; all patients with Guillain Barre syndrome seen between 2012 and 2019 Method All children aged one to 16 years in whom Guillain Barre syndrome was diagnosed based on clinical history, examination, and electrophysiological findings. Institutional review board (IRB) approval was taken and data entered on the designed questionnaire. Chi-square and non-parametric tests were applied for significant association. Results Twenty-three children were included in the study. Of these, 14 were males (60.9%) while the mean age was 5.8 (+4.5) years. Acute inflammatory demyelinating polyneuropathy (AIDP) was found to be the predominant type (9; 39.1%) followed by acute motor and sensory axonal neuropathy (AMSAN) (6; 26.1%), Acute motor axonal neuropathy (AMAN) was diagnosed in four (17.4%) patients. Six (26.1%) patients needed mechanical ventilation and 10 patients (43.5%) required intensive care unit (ICU) care. The majority of the patients (18; 78.3%) received intravenous immunoglobulin (IVIG). Conclusion The study highlights varied electrophysiological types of GBS in Pakistani children, which differ in predominance from previous studies. However, various indicators of poor outcomes that are highlighted in adults, including the older age group, need for mechanical ventilation, and electrophysiological evidence of axonal degeneration, were not significant predictors of outcome in children.
目的 吉兰-巴雷综合征（GBS）是一种自身免疫介导的急性、对称性弛缓性麻痹。吉兰-巴雷综合征有不同的电生理类型，这些类型具有预后意义，且成人和儿童的类型往往有所不同。本研究旨在根据巴基斯坦儿童吉兰-巴雷综合征的电生理类型比较其临床结局，以帮助理解和预测预后。
研究设计 观察性比较研究
地点与时间 伊斯兰堡希法国际医院儿科；2012年至2019年间诊治的所有吉兰-巴雷综合征患者
方法 所有年龄在1至16岁之间、根据临床病史、检查和电生理检查结果诊断为吉兰-巴雷综合征的儿童。获得机构审查委员会（IRB）批准，并将数据录入设计好的问卷。应用卡方检验和非参数检验来确定显著相关性。
结果 23名儿童纳入研究。其中，14名男性（60.9%），平均年龄为5.8（±4.5）岁。发现急性炎症性脱髓鞘性多发性神经病（AIDP）是主要类型（9例；39.1%），其次是急性运动和感觉轴索性神经病（AMSAN）（6例；26.1%），4例（17.4%）患者诊断为急性运动轴索性神经病（AMAN）。6例（26.1%）患者需要机械通气，10例（43.5%）患者需要重症监护病房（ICU）护理。大多数患者（18例；78.3%）接受了静脉注射免疫球蛋白（IVIG）。
结论 该研究强调了巴基斯坦儿童吉兰-巴雷综合征的多种电生理类型，其优势类型与以往研究不同。然而，成人中突出的各种不良结局指标，包括年龄较大、需要机械通气以及轴索性变性的电生理证据，在儿童中并非结局的显著预测因素。
