Does Recurrent Guillain–Barre Syndrome Exist in Children? A Retrospective Observational study

A bstract Background: Guillain–Barre syndrome (GBS) is polyneuropathy involving motor, sensory, and sometimes autonomic nerves. GBS has a monophasic course, and rarely recurrences have been noted; hence, we are reporting this review of recurrent GBS (RGBS). Objectives: We aimed to study the clinical profile and outcomes of RGBS in children. Materials and Methods: A retrospective chart review has been performed of RGBS patients in a pediatric tertiary care health center in Bengaluru from August 2013 to July 2023. Recurrence was defined as per National Institute of Neurological Diseases and Stroke criteria. Results: Eleven RGBS (4.4%) patients out of 248 GBS patients were noted. The male-to-female ratio was 1:1.75. Mean age at presentation was 3.46 (±1.9) years and 8.28 (±4.44) years in the first and second episodes, respectively. The mean interval between two episodes was 4.02 (±3.44) years. All patients had quadriparesis in both presentations with a power of 1/5 at nadir. Respiratory failure needing mechanical ventilation was noted in 63.5% and 45.5% in first and second episodes, respectively. About 66% and 40% patients had axonal neuropathy on the nerve conduction study in the first and second episodes, respectively. Also, 72.7% and 100% of children were treated with intra-venous immunoglobulin in the first and second episodes, respectively. The mean duration of hospital stay was 6 and 3.5 weeks in the first and second episodes, respectively, and 66.6% and 77.8% of patients had complete recovery following the first and second episodes, respectively. Conclusion: RGBS does exist and occurs in approximately 4.4% of children in our study. Recovery took a longer time after the second episode compared to the first episode.