Neurophysiological Subtypes and Short-Term Outcomes of Paediatric Guillain-Barré Syndrome – A Tertiary Care Experience

Open Access

Abstract

Background: Guillain-Barré syndrome (GBS) is the leading cause of post-infectious acute flaccid paralysis in children, typically presenting with rapidly progressive, bilateral weakness beginning in the lower limbs and ascending proximally. It includes several neurophysiological subtypes—both demyelinating and axonal—that differ in clinical features and outcomes. Objective: To determine the frequency of neurophysiological subtypes of paediatric GBS and assess their short-term clinical outcomes. Methods & Materials: This retrospective study reviewed medical records of children diagnosed with GBS at Bangladesh Shishu Hospital from January to December 2024, using the Brighton diagnostic criteria. Socio-demographic data, cerebrospinal fluid findings, and nerve conduction study–based subtypes were documented. Functional outcomes were assessed using the Hughes GBS Disability Scale at discharge and at 3-month follow-up, categorizing scores 0–3 as good and 4–6 as poor outcomes. Statistical analysis was performed using SPSS version 20, with p<0.05 considered significant. Results: Among 45 children, the most common subtype was AMAN (53%), followed by AMSAN (31%) and AIDP (16%). The AMSAN subtype demonstrated significantly greater disease severity, including longer duration of illness, non-ambulatory presentation, progressive course, and higher ICU admission (p=0.01, 0.003, 0.01, 0.03). Although discharge outcomes did not vary significantly across subtypes, AMSAN was associated with poorer 3-month recovery (p=0.04). IVIG use correlated with worse outcomes (p=0.017), reflecting its use primarily in more severe cases. Conclusion: The AMSAN subtype was linked to more severe clinical manifestations and poorer short-term functional outcomes compared to other subtypes. Early neurophysiological classification may help predict prognosis and highlight the need for closer monitoring and targeted rehabilitation in children with AMSAN.