GUILLAIN-BARRE-SYNDROME - A PROSPECTIVE CLINICAL-STUDY IN 25 CHILDRENAND COMPARISON WITH ADULTS

Children who fulfilled the recognized diagnostic criteria for Guillain -Barre syndrome (GBS) were studied propsectively from 1982. After deta iled clinical evaluation and investigation, severity of disease was gr aded on a disability scale ranging from 1 to 6, and the time taken fro m the 1st day of illness to reach important clinical landmarks was not ed. All children were monitored for a minimum of 1 year and observatio ns on them were then compared with those on 92 adults with GBS seen du ring the same period. Twenty-five children, evenly distributed between the sexes, were seen between 1982 and 1989 and constituted 22% of all GBS patients seen during this period. Children had a more acute form of onset than adults, 80% becoming bedbound within 7 days, and a highe r incidence of cranial nerve palsies (76% vs 55%). The incidence of re spiratory paralysis was 40% and of dysautonomia 20%, which was similar to findings in adults. Children fared marginally better than adults: 72% were ambulant at 1 year, 12% bedbound and 16% decreased. The progn osis of ventilated patients was relatively poor in both groups, but ch ildren with the hyperacute form of the disease had twice the probabili ty of adults to attain independent walking at 1 year (0.63 vs 0.33).