engleski

Long-term follow up of children with Guillain-Barré syndrome associated with signs of corticospinal tract involvement

We present 21 children with Guillain-Barr´e syndrome (GBS) at the age 14 months 13 years associated with hyperreflexia or positive Babinski sign in initial or in recovery period, without sharp sensory level and severe or persistent bladder dysfunction, during 1− 8 years of follow up. Clinical examination, electromyoneurography (EMNG), cerebrospinal fluid (CSF) and neuroradiological examination (brain and spinal CT/MR) were performed in studied children. Hyperreflexia or positive Babinski sign were obtained in initial phase in 7, in early recovery period in 13 and in 3 children in both periods. Compound muscle action potentials (CMAP) in range 0.1− 1mV (mean 0.38mV) and motor conduction (CMNV) ranging 15− 33.6 m/s (mean 23.99 m/s) were decreased in initial phase. Inelicitable nerves were detected in 2 children. Neural potentials and F waves were absent initially in 15 patients. Distal latency was prolonged in 10 patients. On follow up improvement of CMAP and CMNV occurred 3− 14 months after first EMNG in 9/21 children. Outcome was excellent in 13 children while 8 patients manifested only mild peroneal gait. Hyperreflexia appeared usually in recovery period, 16 days-13 months after beginning of clinical symptoms, suggesting involvement of upper motor neurons or spinal interneurons occurring mostly in children with axonal GBS or with severe demyelination and secondary axonal degeneration.

Sindrom Guillain Barre; kortikospinalni trakt

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