Epidemiological, clinical, and electrodiagnostic findings in childhood Guillain-Barre syndrome: A reappraisal

We evaluated 61 children with Guillain-Barre syndrome, 14 months to 14 year s of age, admitted to the Hospital Nacional de Pediatria in Buenos Aires. A ccording to the electrodiagnostic findings, they fit into two groups, those with acute motor axonal neuropathy (AMAN) (18 patients) and those with acu te inflammatory demyelinating polyradiculoneuropathy (AIDP) (43 patients). Ninety percent of the children with AMAN resided in suburban or rural areas without running water, whereas half of the AIDP patients lived in a metrop olitan district. Summer and winter months showed a higher incidence of both variants. Children with AMAN were younger, evolved more acutely, reached a higher maximum disability score, required assisted ventilation more often, had lower mean level of cerebrospinal fluid protein, improved more slowly, and had a poorer outcome 6 months and 12 months after onset. Electrophysio logical findings in those with AIDP revealed a pattern of severe diffuse sl owing in children 5 years old or younger and a multifocal pattern in childr en 6 years old or older. This difference was not reflected in the clinical picture. In contrast, AMAN showed a uniform pattern with normal sensory con duction, severely reduced compound muscle action potential amplitude, near normal conduction velocity, and early denervation. Epidemiological, clinica l, electrodiagnostic, cerebrospinal fluid, and prognostic data indicate tha t these variants of Guillain-Barre syndrome should be regarded as different entities.