Abstract
Objectives
To compare clinical, neurological, treatment and outcome of recurrent Guillian-Barré Syndrome (GBS) with non-recurrent GBS. Also, to compare different episodes of recurrent GBS.
Methods
The patient's case records were retrieved retrospectively from the electronic database and case record files. Clinical profile, nerve conduction study, treatment, and outcome details of children with a diagnosis of GBS admitted in Pediatric Intensive Care Unit (PICU) from 2010 to March 2022 were screened. Recurrent GBS cases, as defined by the National Institute of Neurological and Communicative Diseases and Strokes (NINCDS) criteria, were analysed separately. The comparison was made between the first episode of recurrent GBS with non-recurrent GBS, and predictors of recurrence were identified. A comparison of course and outcome was also done between different episodes of GBS in recurrent cases.
Results
Recurrent GBS was observed in 11 (4.7%) out of 234 cases during the study period. The presence of respiratory (p 0.015) and gastrointestinal illness (p 0.007) as preceding illnesses were associated with recurrence. No difference was noted between the first episode of recurrent GBS and non-recurrent GBS. The first and second episodes of GBS in 11 recurrent cases were similar in course and outcome.
Conclusions
Recurrent GBS is underreported but a known entity. No difference was seen between the two episodes of recurrent GBS. However, more data is required to find the features of recurrent GBS so that limited PICU resources can be used judiciously and intervention planned accordingly.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Asbury AK, Cornblath DR. Assessment of current diagnostic criteria for Guillain-Barré syndrome. Ann Neurol. 1990;27:S21–4.
Kuitwaard K, van Koningsveld R, Ruts L, Jacobs BC, van Doorn PA. Recurrent Guillain-Barré syndrome. J Neurol Neurosurg Psychiatry. 2009;80:56–9.
Kuitwaard K, Bos-Eyssen ME, Blomkwist-Markens PH, van Doorn PA. Recurrences, vaccinations and long-term symptoms in GBS and CIDP. J Peripher Nerv Syst. 2009;14:310–5.
Notturno F, Kokubun N, Sekiguki Y, et al. Demyelinating Guillain-Barré syndrome recurs more frequently than axonal subtypes. J Neurol Sci. 2016;365:132–6.
Das A, Kalita J, Misra UK. Recurrent Guillain Barré syndrome. Electromyogr Clin Neurophysiol. 2004;44:95–102.
Taly AB, Gupta SK, Anisya V, et al. Recurrent Guillain Barré syndrome: A clinical, electrophysiological and morphological study. J Assoc Physicians India. 1995;43:249–52.
Grand’Maison F, Feasby TE, Hahn AF, Koopman WJ. Recurrent Guillain-Barré syndrome. Clinical and laboratory features. Brain J Neurol. 1992;115:1093–106.
Baba M, Matsunaga M, Narita S, Liu H. Recurrent Guillain-Barré syndrome in Japan. Intern Med Tokyo Jpn. 1995;34:1015–8.
Basta I, Bozovic I, Berisavac I, et al. Recurrent Guillain-Barré Syndrome - Case series. Neurol India. 2019;67:1536–8.
Pyun SY, Jeong JH, Bae JS. Recurrent Guillain-Barré syndrome presenting stereotypic manifestations, positive antiganglioside antibodies, and rapid recovery. Clin Neurol Neurosurg. 2015;139:230–3.
Hughes RA, Newsom-Davis JM, Perkin GD, Pierce JM. Controlled trial prednisolone in acute polyneuropathy. Lancet. 1978;2:750–3.
Kleyweg RP, van der Meché FG. Treatment related fluctuations in Guillain-Barré syndrome after high-dose immunoglobulins or plasma-exchange. J Neurol Neurosurg Psychiatry. 1991;54:957–60.
Ruts L, van Koningsveld R, van Doorn PA. Distinguishing acute-onset CIDP from Guillain-Barré syndrome with treatment related fluctuations. Neurology. 2005;65:138–40.
Willison HJ. The immunobiology of Guillain-Barré syndromes. J Peripher Nerv Syst. 2005;10:94–112.
Mossberg N, Nordin M, Movitz C, et al. The recurrent Guillain-Barré syndrome: A long-term population-based study. Acta Neurol Scand. 2012;126:154–61.
Jacobs BC, Rothbarth PH, van der Meché FG, et al. The spectrum of antecedent infections in Guillain-Barré syndrome: A case-control study. Neurology. 1998;51:1110–5.
Randhawa MS, Iyer R, Bansal A, et al. Clinical features associated with need for mechanical ventilation in children with Guillain-Barré syndrome: Retrospective cohort from India. Pediatr Crit Care Med. 2022;23:378–82.
Author information
Authors and Affiliations
Contributions
KCS collected the data, analysed the results and wrote the paper; AB analysed the results, wrote the paper and supervised the work; MSR collected and analysed the data; JM helped in writing the manuscript; KN helped in writing the manuscript; SKA helped in writing the manuscript; NS reviewed the NCV data. AB will act as the guarantor for this paper.
Corresponding author
Ethics declarations
Conflict of Interest
None.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Sudeep, K., Bansal, A., Randhawa, M.S. et al. Recurrent Guillain-Barré Syndrome: Clinical Profile and Outcome. Indian J Pediatr 91, 448–454 (2024). https://doi.org/10.1007/s12098-023-04746-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12098-023-04746-y