Last modified: 2018-09-09
Abstract
AIM: To study clinical features, types and prognostic indicators of Guillian Barre syndrome (GBS) at a tertiary care public hospital in northern India.
METHODS: Consecutive children hospitalized with GBS were enrolled. Clinical history, examination and investigations were charted. Factors on admission associated with need for ventilation were analysed. Zika virus DNA was looked for by real time PCR using Trioplex Taqman (CDC reagents) in serum and urine.
RESULTS: 31 children [mean age in months 74.0 (35.7); 61% boys] were enrolled. Mean duration (SD) of illness was 5.25 (3.82) days. 28 (90.3%) had ascending paralysis. Bulbar involvement was seen in 12 (38.7%), extensor plantar reflexes in 2 (6.4%), severe pain in 6 (19.3%), bladder involvement in 7 (22.6%) and hypertension in 8 (25.8%). Nerve conduction studies done in 25 patients revealed acute motor axonal neuropathy in 16 (64%) and acute motor sensory axonal neuropathy in 9 (36%). All fulfilled Brighton criteria for diagnosis. Severity according to Hughes Disability Scale was 4 or 5 in 29 (93.5%). Intravenous immunoglobulin was administered in 28 (90.3%). Six patients required assisted ventilation. Factors associated with ventilation were higher age, change in voice, single breath count, weakness in upper limbs, hypertension, higher neutrophil but lower lymphocytes percentage in blood and higher Hughes Disability Score on admission. Only one patient died. Zika virus DNA was not found in any case.
CONCLUSIONS: Need for ventilation can be predicted in GBS. Zika virus infection is probably not associated with GBS here.