Autonomic dysfunction in childhood guillain - barre syndrome

Autonomic Dysfunction in Childhood Guillain - Barre Syndrome Introduction: Guillain Barre Syndrome (GBS) is the most common cause of acute flaccid paralysis in childhood. It is an acute inflammatory polyneuropathy which is characterized by often ascending and rapidly progressing weakness and loss of deep tendon reflexes. Objective: Frequency of autonomic dysfunction in GBS patients, relationship between autonomic dysfunction with electrophysiological evaluation and spinal MRI findings, and effect of autonomic dysfunction on disease prognosis were recorded retrospectively. Method: Between January 2007 and January 2019, 82 patients being followed in the Istanbul Faculty of Medicine, Department of Pediatric Neurology were enrolled in the study. In this study, 82 GBS patients's files were examined. Results: Forty-eight patients (58.5%) were male and 34 (41.5%) were female. Mean age at the diagnosis was 7±4,2 years. Fifty-three patients (64,6%) had a history of infection before GBS. Signs of autonomic dysfunction were observed in 21 (25,6%) of the patients during the hospitalization period. Hypertension, tachycardia, excessive sweeting, flushing, urinary incontinence or retention and fecal incontinence were the main symptoms. Of the 79 patients (96,3%) with EMG were able to performed; fifty-eight (73,4%) were compatible with AIDP, fourteen (17,7%) with AMAN and three (3,8%) with AMSAN. Spinal MR imaging (n=67) showed increased contrast enhancement in spinal nerve roots and cauda equina in 57 patients (85%). Twenty-three patients (28%) were hospitalized in the pediatric intensive care unit and 14 patients required mechanical ventilation support. There was a statistically significant relationship between the presence of autonomic dysfunction and the need for mechanical ventilation support (p=0.039) and length of stay in intensive care unit (p=0,047). Conclusion: The frequency of autonomic dysfunction was 25.6% in our cohort. Statistically significant relationship were detected between the presence of autonomic dysfunction and need for mechanical ventilation support or length of stay in intensive care unit. Key words: Guillain-Barre Syndrome, Autonomic Dysfunction