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

Almost half of the sample (n=27, 55.1%) complained of back or limb pain and 7 (14.3%) complained of limb paresthesia/numbness. Patients who reported facial weakness numbered 12 (24.5%), ocular abnormalities were reported by 14 (28.6%) patients, and bulbar symptoms were reported by 21 (42.9%). Only 9 (18.4%) cases reported respiratory problems and 10 (20.4%) autonomic involvement, while almost all (n=48, 98%) had impaired reflexes. A series of diagnostic tests revealed abnormal brain MRI (ie, loss of peritrigonal white matter and abnormal signal noted within the right basal ganglia) in 2 (11.8%) patients and abnormal spine MRI (ie, intense enhancement of the terminal nerve roots, significant thickening of the anterior spinal nerve root in the conus medullaris and cauda equine, abnormal enhancement noted at the peripheral sacral anterior root at the level of S1 and S2, and diffuse enhancements seen along the peripheral nerve roots of the spinal cord) in 4 (26.7%). Cerebrospinal fluid analysis showed high protein levels in 15 (62.5%) patients in the sample, with a high white blood cell level in 4 (10.2%) cases. Positive laboratory culture was observed in 7 (14.3%) of the cases ( Table 2 ). The majority of the patients (n=40, 81.6%) received a course of intravenous immunoglobulin and 5 (10%) received a course of intravenous immunoglobulin/steroids, while 4 (8.2%) underwent plasmapheresis. Patients who exhibited a progression to maximum paralysis in #2 weeks numbered 34 (69.4%), while 15 (30.6%) had a progression to maximum paralysis in .2 weeks. At 60 days post emergency department visit, 23 (46.9%) patients still had residual paralysis. Three patients suffered from recurrent GBS and one case from a relapse. No deaths were reported.