Assessment of New Strategies in the Management of Guillain Barre Syndrome: Cairo University

Abstract

The treatment of GBS consists of both supportive and immunomodulatory treatments, among which intravenous immunoglobulin (IVIG) and plasma exchange (PE) are considered most effective [11]. The majority of children achieving a complete functional recovery within 6 months from the onset of illness AbstractBackground: Guillain Barre Syndrome (GBS) deserves a serious attention in children. The treatment of GBS consists of both supportive and immune-modulator treatments, among which intravenous immunoglobulin (IVIG) and plasma exchange (PE) are considered most effective. We aimed to assess the outcome of new strategies in the management of moderate to severe cases.Methodology: This is a retrospective study including 38 GBS children, divided into 3 groups. Group I (30 children) received concomitant therapy of intravenous steroid with IVIG, group II (5 children) received 2 courses, 2 weeks apart, of IVIG (0.4 g/kg/ day) over 5 days each, and group III (3 children) received 2 courses of PE, 5 sessions each, 2 weeks apart.Results: Death occurred only among cases of group I (10/20 cases) 33.3%. Children in group I showed regressive course (p= 0.01). Higher incidence of mechanical ventilation was found in group II (66.6%). Cases in group II stayed longer (median=77days) than those in group I or III. Conclusion:The combination of IVIG and intravenous steroid can be used to hasten recovery in moderate GBS. The use of 10 sessions of PE can decrease the need for mechanical ventilation. Bulbar affection upon admission can be considered as a sign of severity.