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Clinical characteristics and functional outcomes of pediatric Guillain-Barré syndrome admitted to the Neuro-intensive care unit: a decade-long retrospective observational study

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Abstract

Background

Guillain-Barré Syndrome (GBS) remains a significant contributor to acute flaccid paralysis in pediatric patients worldwide. Despite its impact, studies focusing on pediatric GBS requiring intensive care unit (ICU) management are limited. This study aimed to address this gap by exploring the clinical and outcome characteristics of pediatric GBS necessitating ICU care.

Methods

This retrospective observational study, spanning a decade, analyzed the records of 75 pediatric GBS patients admitted to the Neuro-ICU of a tertiary care center in South India. Data included demographics, prodromal symptoms, clinical features, investigations, treatment modalities, and outcomes.

Results

The majority (55/75) of patients were male, with a median age of 12 years. The highest incidence of GBS requiring ICU admission was in the monsoon season. Prodromal symptoms were observed in 56%. Most patients (93.33%) presented with typical GBS symptoms, and 40% had respiratory distress on ICU admission. Acute motor axonal neuropathy (AMAN) was the most common subtype. Approximately 80% required mechanical ventilation, with a median duration of 22.5 days. No in-hospital mortality was recorded. At discharge, most patients had a GBS disability score of 4, improving to 2 at a median follow -up of 228 days.

Conclusions

Pediatric GBS patients requiring ICU care exhibit distinctive characteristics, including a higher prevalence of AMAN subtype, seasonal clustering, and favorable outcomes with intensive treatment. The absence of in-hospital mortality underscores the effectiveness of prompt ICU admission and dedicated Neuro-intensive care.

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Acknowledgements

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Funding

We received no funding for the conduct of the study.

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Authors and Affiliations

  1. Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neuro Sciences (NIMHANS), Neurocentre Faculty Block, 3rd Floor, Hosur road, Bengaluru, Karnataka, 560029, India

    Rohini M. Surve, Prachi Sharma, Roshan Nisal, Dhritiman Chakrabarti, K. Raghavendra, Girish B. Kulkarni & Sriganesh Kamath

  2. Department of Anaesthesiology, Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha, Maharashtra, India

    Roshan Nisal

  3. Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, India

    K. Raghavendra & Girish B. Kulkarni

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  1. Rohini M. Surve
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Contributions

RMS- conception of the work, data acquisition, analysis, interpretation of the data, writing the manuscript. Prachi Sharma- interpretation of the data, drafting and revising the manuscript. Roshan Nisal- data acquisition, and revising the manuscript. Dhritiman Chakrabarti- analysis, interpretation of the data, and revising the manuscript. Raghavendra K - interpretation of the data, and revising the manuscript. Girish B. Kulkarni - interpretation of the data, and revising the manuscript. Sriganesh Kamath - interpretation of the data, and revising the manuscript.

Corresponding author

Correspondence to Rohini M. Surve.

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Surve, R.M., Sharma, P., Nisal, R. et al. Clinical characteristics and functional outcomes of pediatric Guillain-Barré syndrome admitted to the Neuro-intensive care unit: a decade-long retrospective observational study. Neurol Sci 46, 1369–1377 (2025). https://doi.org/10.1007/s10072-024-07862-5

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