Acute polyradiculoneuropathy in children: the Kairouan pediatric department experience. Report of 22 cases

Guillain-Barre Syndrome (GBS) is an acute polyradidulonevritis which is primitive inflammatory and demyelinisant. It represents the most frequent cause of acute peripheric paralysis of the child. To study the epidemiologic, clinic, electromyographic, outcome and therapeutic features of this disease. 22 cases of GBS were reported in the pediatric department of Ibn El Jazzar's hospital of Kairouan from January 1990 to September 2009. The GBS represents a hospital frequency of 0.45 %o . The mean age of the patients was 6.88 years with a sex ratio of 1.2. The prodromic infectious manifestations were observed in 54.5% of cases. The clinic symptomatology was the muscular deficiency observed in all cases with absence of deep reflex an albumincytologic dissociation was observed in 12 cases. The electromyographic manifestations were: an axonal disorder in four cases, axonomyelinic in eight cases and myelinic in seven cases. A specific therapy by intravenous polyvalent immunoglobulin was prescribed for 14 patients. The evolution was favourable in 10 cases with total recovery three cases of drop foot gait were observed, seven patients were lost to follow up and two patients are dead. GB syndrome is the most frequent cause of child acute primitive distal paralysis, since acute polio has been eradicated. Acute Respiratory disorder is the most severe complication this syndrome can lead to in 5% of cases. The course of the disease is often mild and severe scars are only encountered in 5 to 10 % of cases. Indeed, the use intravenous immunoglobulin has utterly changed prognosis.