Síndrome de Guillain-Barré: presentación clínica y evolución en menores de 6 años de edad

• Autores: E. Pérez Lledó, A. Díaz-Vico, Francisco A. Gómez Gosálvez
• Localización: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría ( AEP ), ISSN-e 1696-4608, ISSN 1695-4033, Vol. 76, Nº. 2, 2012, págs. 69-76
• Idioma: español
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• Resumen

  • Introduction Guillain-Barré syndrome (GBS) is an acute polyneuropathy that is difficult to diagnose in young children.

    Objectives To review the form of presentation of GBS in children under six years-old at the time of onset and the symptoms they had until the diagnosis, the findings in the complementary tests, and the progression and prognosis.

    Patients and methods All patients less than 6 years-old who fulfilled the Asbury et al criteria for the diagnosis of GBS were reviewed.

    Results Eight patients with a mean age of 3.4years were included. Of those 75% recorded a previous infection. The symptoms prior to the diagnosis were very heterogeneous which entailed a wide differential diagnosis with many complementary examinations. The mean time to diagnosis was 8.5days. All of them (100%) had motor involvement in the lower limbs, 75% in the upper limbs and 12% in the respiratory muscles. Sensory and cranial nerve involvement was observed in 62.5% and 25%, respectively. Admission to intensive care was required for 25% of the patients. Albumino-cytological dissociation was observed in the CSF in 83.3% and all the electrophysiological tests were positive with different patterns. The prognosis was excellent in all patients.

    Conclusions GBS in children under 6 years-old is difficult to diagnosis due to the signs of onset often being unspecific. This entails a wide differential diagnosis, with the subsequent diagnostic delay. There is a good prognosis in all the electrophysiological sub-types in this age group.