Prevalence and outcomes of Guillain-Barré syndrome among pediatrics in Saudi Arabia: a 10-year retrospective study

Figures & data

Figure 1 Illustration of the total number of pediatric ED visits and the number of diagnosed GBS cases.

Abbreviations: ED, emergency department; GBS, Guillain-Barré syndrome.

Table 1 Patient and disease characteristics

	n (%)
Acute paralyses (N=100)
GBS	49 (49.0)
Axonal (AMAN and AMSAN)	14 (28.6)
AIDP	18 (36.7)
Miller Fisher syndrome	3 (6.1)
Unclassified Guillain-Barre’ syndrome	14 (28.6)
Others	51 (51.0)
GBS	49 (100.0)
Gender
Male	29 (59.2)
Female	20 (40.8)
Age category (years)
1–7	26 (53.1)
8–14	23 (46.9)
Mean ± SD	7±3.7
Antecedent infection
Yes	34 (69.4)
No	15 (30.6)
Season of incident
Fall/winter	22 (44.9)
Spring/summer	27 (55.1)

Note: n, frequency.

Abbreviations: AMAN, acute motor axonal neuropathy; AMSAN, acute motor and sensory axonal neuropathy; GBS, Guillain-Barré syndrome; SD, standard deviation.

Table 2 Frequency of physical examination and diagnostic test results

	n (%)
Physical examination*
Back or limb pain	27 (55.1)
Limb parathesia/numbness	7 (14.3)
Facial weakness	12 (24.5)
Ocular abnormalities	14 (28.6)
Bulbar symptoms	21 (42.9)
Respiratory problems (all intubated)	9 (18.4)
Autonomic involvement	10 (20.4)
Reflexes impaired	48 (98.0)
Diagnostic tests*
Abnormal brain MRI	2 (11.8)
Abnormal spinal MRI	4 (26.7)
High CSF protein	15 (62.5)
High CSF WBC	4 (10.0)
Positive culture (Heliobacter pylori, varicella zoster virus, Brucella, Enterobacter pneumonia, enterovirus, campylobacter)	7 (14.3)
Clinical management*
Plasmapheresis	4 (8.2)
Intravenous immunoglobulin	40 (81.6)
Intravenous immunoglobulin and steroids	5 (10.2)
Intensive care unit admission	26 (53.1)
Clinical outcomes
Progression to maximum paralysis
≤2 weeks	34 (69.4)
>2 weeks	15 (30.6)
Residual paralysis (at 60 days)	23 (46.9)
Recurrent Guillain-Barré syndrome	3 (6.1)
Relapse	1 (1.0)

Note:

* Mutually exclusive.

Abbreviations: CSF, cerebrospinal fluid; MRI, magnetic resonance imaging; n, frequency; WBC, white blood cells.

Table 3 Progression to maximum paralysis and residual paralysis with patient characteristics and physical examination

	Progression to maximum paralysis		Residual paralysis (at 60 days)
	≤2 weeks, 34 (69.4%)	>2 weeks, 15 (30.6%)	Yes, 23 (46.9%)	No, 26 (53.1%)
Gender
Male	24 (82.8%)	5 (17.2%)	15 (51.7%)	14 (48.3%)
Female	10 (50.0%)	10 (50.0%)	8 (40.0%)	12 (60.0%)
	χ^2=5.98, P=0.014*		χ^2=0.653, P=0.419
Age category (years)
1–7	18 (69.2%)	8 (30.8%)	8 (30.8%)	18 (69.2%)
8–14	16 (69.6%)	7 (30.4%)	15 (65.2%)	8 (34.8%)
	χ^2=0.001, P=0.980		χ^2=5.815, P=0.016*
Antecedent infection
Yes	23 (67.6%)	11 (32.4%)	18 (52.9%)	16 (47.1%)
No	11 (73.3%)	4 (26.7%)	5 (33.3%)	10 (66.7%)
	χ^2=0.158, P=0.691		χ^2=1.607, P=0.205
Season of incident
Fall/winter	17 (77.3%)	5 (22.7%)	14 (63.6%)	8 (36.4%)
Spring/summer	17 (63.0%)	10 (37.0%)	9 (33.3%)	18 (66.7%)
	χ^2=1.169, P=0.280		χ^2=4.469, P=0.035*
Back or limb pain
Yes	18 (66.7%)	9 (33.3%)	14 (51.9%)	13 (48.1%)
No	16 (72.7%)	6 (27.3%)	9 (40.9%)	13 (59.1%)
	χ^2=0.210, P=0.647		χ^2=0.853, P=0.445
Limb parathesia/numbness
Yes	3 (42.9%)	4 (57.1%)	3 (42.9%)	4 (57.1%)
No	31 (73.8%)	11 (26.2%)	20 (47.6%)	22 (52.4%)
	F-exact, P=0.117		χ^2=0.210, P=0.647
Cranial symptoms
Yes	20 (74.1%)	7 (25.9%)	16 (59.3%)	11 (40.7%)
No	14 (63.6%)	8 (36.4%)	7 (31.8%)	15 (68.2%)
	χ^2=0.622, P=0.430		χ^2=3.665, P=0.056
Respiratory problems
Yes	9 (100.0%)	0 (0.0%)	6 (66.7%)	3 (33.3%)
No	25 (62.5%)	15 (37.5%)	17 (42.5%)	23 (57.5%)
	χ^2=4.864, P=0.027*		χ^2=1.723, P=0.189
Autonomic involvement
Yes	8 (80.0%)	2 (20.0%)	6 (60.0%)	4 (40.0%)
No	26 (66.7%)	13 (33.3%)	17 (43.6%)	22 (56.4%)
	F-exact, P=0.344		F-exact, P=0.283

Note:

* Significant at P<0.05.

Abbreviations: F-exact, Fisher’s exact test; χ² = Pearson’s Chi-square; P = P-value.

Table 4 Factors associated with level of progression to maximum paralysis and residual paralysis

	Progression to maximum paralysis ≤2 weeks			Residual paralysis at 60 days
	Adj. OR	95% CI	Adj. P-value	Adj. OR	95% CI	Adj. P-value
Gender: males vs females	5.69	1.37–23.7	0.017*	1.22	0.33–4.45	0.765
Age: old (8–14 years) vs young (1–7 years)	0.59	0.14–2.45	0.467	3.90	1.11–13.74	0.034*
Previous infection: yes vs none	0.95	0.22–4.08	0.944	2.20	0.57–8.53	0.256

Note:

* Significance at P<0.05.

Abbreviations: Adj, adjusted, OR, odds ratio, CI, confidence interval.