[P1-126] Comparison of Clinical Profile and Short-term outcome of demyelinating and axonal subtypes of Guillain-Barré syndrome(GBS) in children
[Introduction]Studies comparing theDemyelinating GBS (Dmy-GBS)andaxonal GBS (Ax-GBS) subtype in children are lacking.
[Methods]In this hospital based,prospective,and observational study,consecutive children with GBS were studied to compare the clinical profile and outcome among the subtypes.
[Results]Among 9847 children admitted to the emergency, 95 had acute flaccid paralysis,57of whom hadGBS. Electrophysiologic studies were completed in 56, of whom 20 each hadDmy-GBSandAx-GBS(19 motor axonal), 12 had non-reactive nerves, and 5unclassifiable findings.More children in Ax-GBS group had preceding gastroenteritis (4 vs 2), while Dmy-GBS had upper respiratory infections (12 vs 7). Ataxia was only seen in Dmy-GBS while wrist drop, foot drop and hyperreflexia were seen only with Ax-GBS. Asymmetry of motor findings was more likely in Ax-GBS (10 vs 4, P=0.048).Respiratory muscle involvement (6 vs 3)and artificial ventilation (5 vs 2) was more inAx-GBS.Children with Ax-GBS less likely to be non ambulant at discharge (12 vs 6, p=0.036). Mean disability scoresat hospital discharge (4.9±1.2 vs 4±0.9, p=0.015) and at last follow up (0.7±1.01 vs 0.05±0.2, p=0.016)were higher inAx-GBS. Children with Dmy-GBS were more likely to achieve normalcy on follow up (19 vs 12, p=0.023).
[Conclusion]Children with axonal GBS have severe clinical course and more short term morbidity and slower recovery.
[Methods]In this hospital based,prospective,and observational study,consecutive children with GBS were studied to compare the clinical profile and outcome among the subtypes.
[Results]Among 9847 children admitted to the emergency, 95 had acute flaccid paralysis,57of whom hadGBS. Electrophysiologic studies were completed in 56, of whom 20 each hadDmy-GBSandAx-GBS(19 motor axonal), 12 had non-reactive nerves, and 5unclassifiable findings.More children in Ax-GBS group had preceding gastroenteritis (4 vs 2), while Dmy-GBS had upper respiratory infections (12 vs 7). Ataxia was only seen in Dmy-GBS while wrist drop, foot drop and hyperreflexia were seen only with Ax-GBS. Asymmetry of motor findings was more likely in Ax-GBS (10 vs 4, P=0.048).Respiratory muscle involvement (6 vs 3)and artificial ventilation (5 vs 2) was more inAx-GBS.Children with Ax-GBS less likely to be non ambulant at discharge (12 vs 6, p=0.036). Mean disability scoresat hospital discharge (4.9±1.2 vs 4±0.9, p=0.015) and at last follow up (0.7±1.01 vs 0.05±0.2, p=0.016)were higher inAx-GBS. Children with Dmy-GBS were more likely to achieve normalcy on follow up (19 vs 12, p=0.023).
[Conclusion]Children with axonal GBS have severe clinical course and more short term morbidity and slower recovery.