CHILDHOOD GUILLAIN-BARRE-SYNDROME - CLINICAL PRESENTATION, DIAGNOSIS,AND THERAPY

A rapidly progressive, generally symmetric, ascending flaccid parapare sis or quadriparesis that develops in an infant or child constitutes a n uncommon but important pediatric neurologic emergency that requires immediate evaluation and treatment. The differential diagnosis primari ly includes acute neuropathies, most commonly the childhood Guillain-B arre syndrome and, rarely, acute transverse myelitis or infantile poli omyelitis. A clinical distinction may be difficult in the younger chil d in whom detailed sensory examination is not possible. Although most children with Guillain-Barre syndrome usually have a benign and relati vely limited clinical illness, some become severely ill, requiring int ubation and careful intensive monitoring. To date, no well-controlled multi-institutional studies of treatment with either plasmapheresis or intravenously administered immunoglobulin have been developed in chil dren despite the success of these modalities in adults. A review of th e data available using these therapies is included in this study.