Clinical audit on the management of Guillain-Barre syndrome cases admitted to Assiut University Children Hospital

Introduction
Guillain-Barré syndrome (GBS) is the most common cause of acute flaccid paralysis in children. It is characterized by progressive, symmetrical weakness, and areflexia in a previously healthy child. GBS should be diagnosed quickly in patients presenting with rapidly progressive paralysis. Meticulous monitoring and supportive care are needed in all GBS patients. Efforts focus on the follow-up of clinical course and outcome to improve the care and treatment of individual patients.
Materials and methods
The study included pediatric patients with GBS referred to Assiut University Children Hospital in 9 months from November 2016 to July 2017. Information was taken from resident doctors and mothers.
Results
Intravenous immunoglobulin (IVIG) was administered to 17 (80.95%) cases. Four (19.05%) cases who presented in the improving phase of motor disability were managed supportively and recovered completely. Plasmapheresis was done to three (14.3%) cases, who did not respond well to IVIG. Complete recovery was observed in 17 (80.95%) cases and four (19.05%) cases experienced only incomplete recovery.
Discussion
Nerve conduction velocity is very useful to diagnose GBS. IVIG and supportive care are considered key elements in the management of childhood GBS. IVIG administration early in the course of the disease results in better recovery. Plasmapheresis may be an effective option in cases with poor response to IVIG therapy.