Pradeep Kumar Gupta
Norvic International Hospital, Nepal
Title: How different is demyelinating and axonal subtypes of Guillain-Barré syndrome in children? A study from tertiary care centre in northern India
Biography
Biography: Pradeep Kumar Gupta
Abstract
Introduction: Studies comparing the Demyelinating GBS (Dmy-GBS) and axonal GBS (Ax-GBS) subtype in children are lacking. Methods: In this hospital based, prospective and observational studies, 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, 57 of whom had GBS. Electrophysiologic studies were completed in 56, of whom 20 each had Dmy-GBS and Ax-GBS (19 motor axonal), 12 had non-reactive nerves and 5 unclassifiable findings. Mean age of onset in Dmy-GBS was 55 months while Ax-GBS occurred later at 84 months. Mean time from onset of symptoms to hospital admission was more in Dmy-GBS 18 days to 8 days in 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 in Ax-GBS. The average duration of hospital stay was more in Ax-GBS 16 days to 11 days in Dmy-GBS. Children with Ax-GBS less likely to be non-ambulant at discharge (12 vs. 6, p=0.036). Mean disability scores at 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 in Ax-GBS. IVIg was the treatment modality and was tolerated well with no side effects reported with no relapse of symptoms after treatment. Conclusion: Axonal and demyelinating subtypes of GBS are equally common in children of North India. Children with axonal GBS have severe clinical course and more short term morbidity and slower recovery.