A Study of Clinical Profile and Prognostic Factors in Pediatric Patients with Guillain–Barré Syndrome

To study the clinical presentation, epidemiology, diagnostics, management, complications, outcomes, disease progression (using Hughes disability grading), and prognostic factors (age, sex, antecedent illness, Medical Research Council (MRC) score, duration of weakness, time to peak weakness, autonomic dysfunction, electrophysiology, ventilatory support) in patients with Guillain-Barr syndrome (GBS).Materials and methods: This prospective analytical study was conducted at BJ Medical College, Ahmedabad (January 2023-June 2024).It included children (1-12 years) with GBS diagnosed as per Asbury criteria and NCV studies, admitted to the pediatric intensive care unit/ward.Detailed analysis of history, investigations, and treatment was done.Prognostic factors and ventilation needs were assessed.Patients were monitored from admission to discharge and followed for 6 months using Hughes grading.Data analysis was performed using appropriate statistical methods.Results: A total of 95 GBS patients meeting the inclusion criteria were enrolled.Most (50.5%) were aged 5-9 years, with a male predominance (62.1%).Cases peaked between July and October, with respiratory illness being the most common antecedent (38.9%).Bilateral lower-limb weakness was the most frequent presentation (69.4%).Cranial nerve affection was most commonly seen in form of bulbar palsy (40%).The acute motor axonal neuropathy subtype was found to be most common (35.7%), lower MRC scores, autonomic instability, and bulbar palsy predicted ventilation needs.Acute inflammatory demyelinating polyradiculoneuropathy (AIDP) patients showed the most significant improvement over time. Conclusion:Early diagnosis and intervention are crucial in managing GBS.Lower MRC scores, autonomic instability, and bulbar involvement predict poorer outcomes, including the requirement of ventilatory support.Seasonal patterns and antecedent illnesses influence disease presentation and progression.All GBS subtypes showed significant improvement in disability over time, especially AIDP.Clinical significance: There should be close monitoring of lower-limb weakness, respiratory issues, autonomic instability, MRC scores, and development of bulbar palsy to prognosticate patients and improve outcomes.Public health awareness, comprehensive rehabilitation, and regular follow-ups support recovery, as evidenced by significant disability improvements over time.