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

GBS constitutes the majority of acute flaccid paralysis cases among children, yet it is less frequent compared to the prevalence among adults. The most affected age group among pediatrics was among those 1-4 years old. 23 The European population-based annual incidence rate was 1.70/100,000 persons. 24 One study targeting children of age ,16 years showed an annual incidence of 0.4/100,000. 1 Epidemiological studies of GBS in Asia are few and it is speculated that there are geographical differences with regards to the various types of GBS. 25 For instance, the prevalence of AIDP in two Far Eastern settings was 20/30 (66.7%) 26 and 324/661 (49%), 27 much higher than that reported in this setting as 18/49 (17.9%). The average age of children who complained of GBS in this setting was 8.59±4.99 years, which was slightly higher than that reported in the literature. 28 A 10-year study showed that 2.1/100,000 acute paralysis cases were GBS, of which the male-to-female ratio was 1.5:1. 24 Furthermore, the incidence of GBS among males increased by 28% and among women increased by 14%, for every 10-year increment of age. 24 Findings in this setting were similar to previous studies that showed a higher incidence among males. 4, 30 Studies have shown that GBS was preceded by infections in 40%-70% of the reported cases. 31 In one Asian setting, preceding infections were prevalent in 34.9% of the GBS cases, 27 a much lower figure than that reported in this setting (69.4%). Recipients of vaccines such as the varicella zoster virus vaccine were at higher risk for the demyelinating subtypes of GBS. 32 Furthermore, in 50%-70% of GBS cases, respiratory or gastrointestinal infections have been reported 1-2 weeks prior to the incident. 33 On the other hand, studies conducted in Western and Arab countries showed higher occurrence of GBS during the winter and early summer seasons. 3, 4, 8, 13 The seasonal incidence of GBS in one study was 22% in autumn, 25% in winter, 27% in spring, and 26% in summer. 29 These figures were comparable to findings in this study where 44.9% of GBS were admitted in autumn and winter.