Magnitude, clinical presentations, outcomes and Associated factors of guillain-barre syndrome among Pediatrics admited jumc southwest, Ethiopia

Abstract

Background: Guillain-Barre Syndrome (GBS) is a rare but serious neurological disorder in children, often requiring intensive care. This study aimed to evaluate the prevalence, clinical characteristics, management, outcome and its predictor of pediatric GBS cases admitted to JUMC (a tertiary care center) over a five-year period. Methods: An institution based cross-sectional study was conducted on 72 pediatric patients (<15years) admitted to JUMC for the diagnosis of GBS fulfilling the Brighton Criteria for GBS. Clinical features, diagnostic procedures, treatments, outcomes and its predictors were reviewed. Statistical associations between key clinical variables and outcomes were analyzed using logistic regression. Results: The prevalence of GBS was 0.9 per 100,000 children in the general pediatric population and 0.5 per 100 pediatric hospital admissions, it’s found to be a peaked in children aged 1–5 years. Males constituted 62.5% of the study, with a median age of 8.3 years. The majority (84.5%) presented with ascending symmetrical weakness, with 85% reaching peak weakness within two weeks. Quadriplegia was noted in 48.5% of patients, and neuropathic pain was reported in 37%. Antecedent infections, particularly upper respiratory tract infections, were identified in 80.6% of cases, with most cases occurring between September and December. Cranial nerve involvement was observed in 38.9.3%, and autonomic dysfunction in 27.8%. Intensive care was required for 58.9% of patients, with 37.3% needing mechanical ventilation. Respiratory failure and requirement for mechanical ventilation significantly increased the odds of mortality (AOR = 7.6, p = 0.007; AOR = 9.2, p = 0.027). Complications included ventilator associated pneumonia (42%), aspiration pneumonia (27%), urinary tract infections (17%), and bed sore (3%) Lumbar punctures revealed albumin cytological dissociation in 66.7% of cases. Despite this, only 9.6% of patients received intravenous immunoglobulin (IVIG), and 15% of these experienced treatment-related worsening. At discharge, 45% of patients showed partial recovery, 40.2% had no motor improvement without progression, and 5.6% died. The primary causes of death were respiratory failure and autonomic dysfunction. ii Conclusion: Pediatric GBS presents significant morbidity and mortality, with respiratory failure and requirement for mechanical ventilation being critical determinants of outcomes. Early recognition of respiratory complications and timely intensive care interventions are essential to improve outcomes and survival rate. Future studies should explore the role of electrophysiological testing, long term outcome and optimal therapeutic strategies, including broader use of IVIG.