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  • Updated 11.23.2020
  • Released 11.15.1999
  • Expires For CME 11.23.2023

Guillain-Barre syndrome in children

Introduction

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. The pediatric presentation differs from adult presentations in that children more commonly complain of sensory symptoms such as pain and often present with gait instability manifested as gait ataxia. Although rare so far, pediatric Guillain-Barré syndrome in the setting of severe acute respiratory syndrome corona virus 2 has been reported during the current pandemic.

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 (46). 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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