Abstract
Backgroud: The aim was to investigate clinical features and long-term prognosis of asymmetric childhood Guillain-Barré syndrome (GBS). Methods: In a retrospective cohort study, standardized data from all children with GBS seen at the Wuhan Children’s Hospital were collected regarding clinical presentation, auxiliary examinations and long-term outcome. We compared asymmetry GBS with symmetry GBS. Asymmetry GBS was defined by Medical Research Council (MRC) grade and motor nerves conduction in bilateral limbs. Recovery was defined as a return to normal life with a DSS of 0. Results: GBS was diagnosed in 72 children. 12（16.67%）were asymmetry GBS compared to 60 symmetry GBS . In asymmetry GBS, six children were transient asymmetry weakness and six children were persistent asymmetry weakness. Compared to symmetry weakness GBS, asymmetry weakness GBS had more preschool children (75% vs 25%, P=0.005), longer days on hospital(26.5(15-37) days vs 11(9-15) days, p =0.000), more mechanical ventilation(MV) (50% vs 8.33%, p=0.000), higher Disease severity score(DSS)at nadir of disease(4(3-5) vs 3(1-4), p=0.010), more axonal subtypes(50% vs 15%, p=0.013) and more complications(58.33% vs 8.33%, p=0.000). Eight children had sequelae and sixty-four children had recovery. Compared to recovery group, sequelae group had more axonal subtypes(62.5% vs 15.63%, p=0.002) and more persistent asymmetry weakness(62.5% vs 4.69%, p=0.000). In six persistent asymmetry GBS, 5(83.33%) had abnormal EEG (electroencephalogram) results, 3(50%) children had mild to marked pleocytosis in CSF and 5(83.33%) had sequelae. Conclusions: In conclusion, asymmetry GBS had two types, namely transient and persistent asymmetry weakness. Asymmetry GBS indicated a more complex condition during disease. Most of persistent asymmetry GBS had clinical or subclinical infectious disease and poor prognosis. Inflammatory in anterior horn cells or nerve root by infectious disease may be the possible function in persistent asymmetry GBS.
The clinical features and long-term prognosis of asymmetry childhood Guillain-Barré syndrome: a 5-year follow-up.
