Predictive factors for achieving independent walking in children with Guillain-Barre syndrome

• Published in: Pediatric research Vol. 82; no. 2; pp. 333 - 339
• Main Authors: Barzegar, Mohammad, Toopchizadeh, Vahideh, Maher, Mohammad H K, Sadeghi, Paria, Jahanjoo, Fatemeh, Pishgahi, Alireza
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01.08.2017; Nature Publishing Group
• Subjects: 692/308/3187; 692/53/2423; 692/617/375; 692/700/228/491; Adult; Baby supplies; Child, Preschool; clinical-investigation; Female; Guillain-Barre syndrome; Guillain-Barre Syndrome - physiopathology; Humans; Male; Medicine; Medicine & Public Health; Parameter estimation; Pediatric Surgery; Pediatrics; Prospective Studies; Walking
• ISSN: 0031-3998; 1530-0447
• DOI: 10.1038/pr.2017.67

Background To determine the predictors of achieving independent walking at 2 and 6 months after onset of weakness in children with Guillain-Barre syndrome (GBS). Methods Children with GBS admitted to the Tabriz Children’s Hospital were studied prospectively. All patients had frequent clinical evaluations until achieving independent walking. Unaided walking at 2 and 6 months and factors influencing these outcomes were determined using both univariate and multiple analyses. Results Between 2003 and 2014, 324 children (mean age: 5.3±3.66 years) were admitted. The mean duration to independent walking was 2.97±3.02 months; 90.5% of patients could walk independently at 6 months. In the univariate analysis, disability score of >3 ( P =0.03), autonomic nerve involvement ( P =0.003), cranial nerve involvement ( P =0.008), and absent compound muscle action potential (CMAP; P =0.048) were found to be significantly associated with poor walking outcome at 6 months. In the multivariate analysis, cranial nerve involvement ( P =0.008) and absence of CMAP ( P =0.022) were independently associated with poor functional outcome. Conclusion Disability score >3, cranial and autonomic nerve involvement, and absence of CMAP were predictors of independent walking in childhood GBS in this study; early rehabilitation program may prevent further impairments secondary to immobility in these patients.