SEVERE GUILLAIN-BARRE-SYNDROME IN CHILDHOOD TREATED WITH HUMAN IMMUNEGLOBULIN

Thirteen children with severe Guillain-Barre syndrome were treated wit h human immune globulin, Patients received a mean total dose of 1.9 gm /kg of human immune globulin for 2 or 5 days, To evaluate the relation ship between the response to human immune globulin and electrodiagnost ic findings, we compared the clinical outcome of 3 groups of children, The first group consisted of 9 children with electrophysiologic evide nce of a mean amplitude of the compound motor action potentials larger than 10% of the lower limit of normal, The second group of 4 children had inexcitable motor nerves, Children in the second group required l onger periods to improve one functional grade (mean 67.3 days vs 18.8 days) and to reach grade 2 (219 days vs 32.7 days), Moreover, children in the second group were more disabled after 3 and 6 months, and they all remained with distal atrophy and weakness after 7 months of follo w-up, Furthermore, the outcome of children in the second group was no different from that of a historic control of 5 untreated children with severe Guillain-Barre syndrome and similar electrophysiologic finding s, Human immune globulin treatment in children with severe Guillain-Ba rre syndrome is safe, easy to administer, and does not increase the nu mber of relapses, Nevertheless, it does not seem to benefit children w ith low mean compound motor action potential amplitude.