Guillain-Barre syndrome in children

David T Hsieh MD (Dr. Hsieh of the Uniformed Services University of the Health Sciences and The University of Texas Health Science Center at San Antonio has no relevant financial relationships to disclose.)
Bernard Maria MD, editor. (Dr. Maria of Icahn School of Medicine at Mount Sinai and Director of Pediatric Neurology and Developmental Medicine at Goryeb Children)
Originally released November 15, 1999; last updated October 24, 2016; expires October 24, 2019

Overview

Guillain-Barré syndrome is an acquired, autoimmune-mediated radiculopolyneuropathy characterized by an ascending progressive motor weakness and areflexia. Sensory, autonomic, and brainstem findings can also occur. In this article, the author provides updates on the association of mycoplasma pneumonia with Guillain-Barre syndrome.

Key points

 

• Guillain-Barré syndrome is an acquired, autoimmune-mediated radiculopolyneuropathy characterized by an ascending progressive motor weakness and areflexia.

 

• Although weakness is the hallmark symptom, differing presentations in children, as opposed to adults, can include predominant symptoms of gait ataxia or pain, and a higher incidence of cranial nerve abnormalities.

 

• Regional differences in presentation are observed, with demyelinating subtypes more prevalent in Western countries, such as the United States, and axonal subtypes more prevalent in Asia and in Mexico.

 

• The most significant complication is the need for respiratory support, which is reported in 10% to 28% of children.

Historical note and terminology

Guillain-Barré syndrome is an acquired, autoimmune-mediated radiculopolyneuropathy characterized by an ascending progressive motor weakness and areflexia. Sensory, autonomic, and brainstem findings can also occur. This syndrome was first described by Landry in 1859, later by the French army neurologists Guillain and Barré in 1916 (Ropper 1992). The observation by Guillain and Barré that this weakness occurred with "albuminocytologic dissociation" (ie, an elevated CSF protein with a normal CSF cell count) allowed this entity to be distinguished from polio and other neuropathies.

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