Surve Rohini M, Sharma Prachi, Nisal Roshan, Chakrabarti Dhritiman, Raghavendra K, Kulkarni Girish B, Kamath Sriganesh
Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neuro Sciences (NIMHANS), Neurocentre Faculty Block, 3rd Floor, Hosur road, Bengaluru, Karnataka, 560029, India.
Department of Anaesthesiology, Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha, Maharashtra, India.
Neurol Sci. 2025 Mar;46(3):1369-1377. doi: 10.1007/s10072-024-07862-5. Epub 2024 Nov 7.
Guillain-Barré Syndrome (GBS) remains a significant contributor to acute flaccid paralysis in pediatric patients worldwide. Despite its impact, studies focusing on pediatric GBS requiring intensive care unit (ICU) management are limited. This study aimed to address this gap by exploring the clinical and outcome characteristics of pediatric GBS necessitating ICU care.
This retrospective observational study, spanning a decade, analyzed the records of 75 pediatric GBS patients admitted to the Neuro-ICU of a tertiary care center in South India. Data included demographics, prodromal symptoms, clinical features, investigations, treatment modalities, and outcomes.
The majority (55/75) of patients were male, with a median age of 12 years. The highest incidence of GBS requiring ICU admission was in the monsoon season. Prodromal symptoms were observed in 56%. Most patients (93.33%) presented with typical GBS symptoms, and 40% had respiratory distress on ICU admission. Acute motor axonal neuropathy (AMAN) was the most common subtype. Approximately 80% required mechanical ventilation, with a median duration of 22.5 days. No in-hospital mortality was recorded. At discharge, most patients had a GBS disability score of 4, improving to 2 at a median follow -up of 228 days.
Pediatric GBS patients requiring ICU care exhibit distinctive characteristics, including a higher prevalence of AMAN subtype, seasonal clustering, and favorable outcomes with intensive treatment. The absence of in-hospital mortality underscores the effectiveness of prompt ICU admission and dedicated Neuro-intensive care.
吉兰-巴雷综合征（GBS）仍是全球小儿急性弛缓性麻痹的重要病因。尽管其影响重大，但针对需要重症监护病房（ICU）管理的小儿GBS的研究有限。本研究旨在通过探讨需要ICU护理的小儿GBS的临床和结局特征来填补这一空白。
这项回顾性观察研究历时十年，分析了印度南部一家三级医疗中心神经ICU收治的75例小儿GBS患者的记录。数据包括人口统计学、前驱症状、临床特征、检查、治疗方式和结局。
大多数（55/75）患者为男性，中位年龄为12岁。需要入住ICU的GBS发病率最高的季节是季风季节。56%的患者出现前驱症状。大多数患者（93.33%）表现出典型的GBS症状，40%的患者在入住ICU时出现呼吸窘迫。急性运动轴索性神经病（AMAN）是最常见的亚型。约80%的患者需要机械通气，中位持续时间为22.5天。未记录到院内死亡病例。出院时，大多数患者的GBS残疾评分为4分，在中位随访228天时改善至2分。
需要ICU护理的小儿GBS患者表现出独特的特征，包括AMAN亚型的患病率较高、季节性聚集以及强化治疗后预后良好。未发生院内死亡强调了及时入住ICU和专门的神经重症监护的有效性。
