Guillain-Barré Syndrome in Children
What is Guillain-Barré syndrome?
Guillain-Barré syndrome (GBS) is a temporary, but often life-threatening, disorder that affects the nerves in the body. GBS can result in muscle weakness, pain, and even temporary paralysis of the facial, chest, and leg muscles. Paralysis of the chest muscles can lead to breathing problems and death if not treated.
What causes Guillain-Barré syndrome?
The exact cause of Guillain-Barré syndrome is unknown. Theories suggest that GBS is an autoimmune disorder (where the body's immune system fights or attacks the peripheral nervous system) that can occur after a viral infection, surgery, trauma, or reaction to an immunization. According to the Centers for Disease Control and Prevention (CDC), about two-thirds of people who develop symptoms of GBS do so in a few days or weeks after diarrhea or respiratory illness.
GBS can affect people of all ages.
Most children diagnosed with GBS experience a full recovery with no further complications. Recovery often starts within a few weeks after the onset of symptoms.
What are the symptoms of Guillain-Barré syndrome?
The following are the most common symptoms of Guillain-Barré syndrome. Symptoms can occur a bit differently in each child. They can include:
Your child may experience muscle weakness over a period of 1 to 2 weeks. The full extent of the weakness can last up to 1 to 2 months with an anticipated full recovery at least 1 to 2 years after diagnosis. The symptoms of Guillain-Barré syndrome can look like other health conditions. Be sure your child sees his or her healthcare provider for a diagnosis.
How is Guillain-Barré syndrome diagnosed?
The healthcare provider will ask about your child’s symptoms and health history. He or she will give your child a physical exam. The diagnosis of GBS is made after the sudden onset of specific symptoms and after certain tests including:
Lumbar puncture (spinal tap). A special needle is placed into the lower back, into the spinal canal, which is the area around the spinal cord. The pressure in the spinal canal and brain can then be measured. A small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to determine if there is an infection or other problems. CSF is the fluid that bathes your child's brain and spinal cord.
Electromyogram (EMG). A test that measures the electrical activity of a muscle or a group of muscles. An EMG can detect abnormal electrical muscle activity due to diseases and neuromuscular conditions.
Pulmonary function test. A breathing test done by a respiratory therapist to determine the lung capacity and strength of the respiratory muscles, often used to determine the need for ventilator support in those with the disorder.
Treatment of Guillain-Barré syndrome
Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.
There is no cure for Guillain-Barré syndrome. The key to medically managing GBS is early detection. This condition is usually reversible, but can be life threatening. A child with GBS will be hospitalized in the intensive care unit (ICU) and will be closely monitored by the healthcare team.
The goal of treatment is to prevent breathing problems and provide supportive care (relief of symptoms) to your child. Medicines are used to control pain and other conditions that may be present. In addition, treatments such as plasmapheresis or immunoglobulin administration may be used to suppress the immune system or reduce inflammation caused by the immune system's response to the disease. Plasmapheresis is a procedure which removes the plasma (liquid part of the blood) and replaces it with other fluids. Antibodies are also removed with the plasma, which is thought to help reduce the symptoms of the disease. Another treatment is giving immunoglobulin, a blood product that helps to decrease the immune system's attack on the nervous system. Because plasmapheresis is a complex procedure that can be hard to do on young children, immunoglobin therapy is generally the first-line approach to treating GBS. In severe cases, a breathing machine may be required to help your child breathe easier.
During the course of this condition, your child may develop stiff muscles and contracted joints. As your child recovers, physical, occupational, or speech therapy may be needed to help him or her regain muscle strength and speech and swallowing skills.
The healthcare team educates your family after hospitalization on how to best care for your child at home and outlines specific clinical problems that require immediate medical attention by his or her healthcare provider. A child with GBS requires frequent medical evaluations following hospitalization. Make sure your child gets enough rest and activity.