Prevalence and outcomes of Guillain-Barré syndrome among pediatrics in Saudi Arabia: a 10-year retrospective study

Asiri, Safiyyah; Altwaijri, Waleed A; Ba-Armah, Duaa; Al Rumayyan, Ahmed; Alrifai, Muhammad T; Salam, Mahmoud; Almutairi, Adel F

Driven by speculation that respiratory failure is rare in children with GBS, one study noted that 4/40 (10%) children required mechanical ventilation. 44 The rate of GBS patients who were in need of respiratory assistance in this setting was 18.4%, which was slightly higher than a rate reported by one setting. 26 Cranial nerve involvement is common in GBS patients, especially in the AIDP variant, as it ranged from 50% to 75%. 5, 20 Cranial nerve involvement is associated with respiratory paralysis and needs ventilator support, but overall it does not affect the clinical prognosis. 45 Among the various clinical patterns of GBS, autonomic disturbances, manifested by arrhythmia and blood pressure fluctuations, were found in 4%-17% of the cases which increases the morbidity and mortality among them. 4, 13, 19 In this setting, GBS patients with autonomic involvement were slightly higher (20.4%), yet no deaths were reported. Moreover, an elevated cerebrospinal fluid protein level has been reported in 66.7% of GBS cases, which was comparable to findings in this setting. 46 limitations A number of limitations have been observed in this study. The retrospective analysis of previously collected data has been built on preexisting disease information recorded on medical charts. These data were originally collected for clinical rather than research purposes, which might have overlooked some patients and disease characteristics that might be of interest to readers. One of the main limitations is the fact that rehabilitation was not investigated in this study as a potential confounder for residual paralysis. Loss of follow-up, which is beyond 60 days, is another limitation, which could have reported the residual paralysis up to 12 months after the diagnosis. Due to that fact that this study reports findings from a relatively small sample size, it might not be generalizable to the populations residing in the whole Gulf region. This study has not reported the population incidence of GBS during the 10-year period, but rather limited its interest to the prevalence of GBS among acute paralytic cases. Last but not least, Zika virus has been reported to be a potential preceding trigger of GBS, 14, 15 yet no positive cases for Zika virus have so far been reported in Saudi Arabia.