بررسي 20ساله سندرم گيلن باره در كودكان

Guillain Barre Syndrome: a 20-year study on pediatrics

Background: Guillian Barre Syndrome (GBS) is the most common cause of acute paralysis. It may occurs following infection, inflammation, vaccination, surgery, and malignancies or may be idiopathic. Acute symmetrical flaccid ascending paralysis begins in distal part of lower exterimities and it extends toward upper exterimities during few hours to few days. Increased cerebrospinal fluid protein and decreased nerve conduction velocity helps for diagnosis. We studied children who were admitted for GBS in Shiraz during 20 years ago. Materials and Methods: It was an existing data type study. From medical files of patients, those who have diagnosed GBS were selected. Data including age, sex, season, month, duration of admission, infections, blood pressure and clinical manifestations were recorded. Results: 78 patients were studied. Mean age of patients was 6.26 ranged between 4 months and 14 years. The most of patients were in 1-5 years old age group. male to female ratio was 1.6. There was no relatio between frequency of admission and seasons. 45% had positive history of upper respiratory tract infection during the last ten days before hospitalization. In an interesting case, the disease was occurred following kala azar. 31% had cranial nerve involvement, mostly in fascia/ nerve. 44% had respiratory problems and 23% need to mechanical ventilator. Swallowing and sphincter dysfunction were present in 30% and 17%, respectively. Blood pressure changes, mostly hypertenstion, were seen in 9% of patients,. Recurrence and death were occurred in 4.4% and 8%, respectively. Conclusion: Guillain Barre Syndrome is a multifactorial syndrome in which infections, diseases and environmental factors have important role in its etiology. Due to disability and even death, Further studies is recommended to find the etiology, treatment and prevention of GBS.