چكيده لاتين :
Objective:
Guillain-Barre syndrome (CBS) is the most common cause of acute
neuromuscular paralysis in children, its pathogenesis most probably involving an autoimmune response to Schwann cell or peripheral nerve myelin antigens.
Steroid regimes improve demyelinating diseases such as chronic CBS. We assessed the benefit of high dose methylprednisolone (MP) combined with Intravenous immunoglobulin (MP-IVIC) and compared the effectswith those of IVIC per se in children with CBS.
Materials& Methods:
Thirty-six children , aged between 1-12 yearswere randomized to receive IV MP 20mglkglday combined with IVIC 400 rug/kg/day (MP-IVIC) or IVIC per se at same dose for 5 days. All patients were diagnosed by standard clini cal criteria and entered the trial within less than 2 weeks of the onset of neurological symptoms. All patients were too weak to walk. Functional grade (FC) was at 3 or more (able to walk with support).
Results:
In the MP-MC group, FC improved at least one grade after 5 days of treatment (P<0.05), while those who received only IVIC had no significant improvement in their FCsafter 5 days of treatment (P<0.2). The main outcome result remained significantly in favor of the MP-MC treatment group.
There was no significant difference in improvement of one or more FC between the groups, after 4 weeks of treatment (secondary outcome).
The median time required to improve one FC was 12 days in MP-IVIC as
compared with 21 days in IVIC per se (P<0. 5), and the median time required to reach the stage of walking independently (FC=2) was 36 days in MP-MC as compared to 43 days in IVIC per se (P<0.03).
Conclusion:
This study suggests that combined treatment with MP-MC in children with CBS does cause rapid improvement in the acute phase, but does not result in any significant difference in the long term outcome.
