V. Toopchizadeh, M. Barzegar, Negar Taleschian-Tabrizi, Fariba Pashazadeh, Nasim Rashedi
{"title":"Long-term Disability and Poor Outcome Predictors of Guillain-Barre Syndrome in Children: A Systematic Review","authors":"V. Toopchizadeh, M. Barzegar, Negar Taleschian-Tabrizi, Fariba Pashazadeh, Nasim Rashedi","doi":"10.32598/jpr.11.1.1066.1","DOIUrl":null,"url":null,"abstract":"Background: Guillain-Barre syndrome (GBS) is an immune-mediated polyneuropathy and a common cause of acute ascending weakness in children. Objectives: This study aims to report long-term disability and poor outcome predictors of GBS in children. Medline (via Pubmed), Embase, Cochrane Library, Web of Science, and Scopus database was searched for relevant studies until April 2022, with a designated search strategy, using MeSH terms and free keywords. Methods: Studies evaluating functional outcomes of GBS in children with at least one year of follow-up were included. All studies achieved acceptable quality for inclusion. After selecting studies based on inclusion criteria, data were extracted based on a modified standardized Joanna Briggs Institute (JBI) data extraction tool, and the methodological quality of studies were reviewed using the Joanna Briggs Institute (JBI) critical appraisal tool. Results: Fourteen studies were included in this systematic review consisting of 1141 patients (647 males, 466 females, and 28 unclassified). Follow-up duration varied from one year to 11 years. The prevalence of the GBS subtype was as follows, acute inflammatory demyelinating polyneuropathies (AIDP) 46.6%, acute motor axonal neuropathy (AMAN) 30.2%, acute motor and sensory axonal neuropathy (AMSAN) 6.8% and Miller fisher 6.1%. The most commonly reported poor outcome after at least one year of follow-up was walking disabilities and gait disorders. Motor deficits and weakness, sensory complaints, including pain or paresthesia and fatigue were other prevalent residual symptoms. Axonal form of GBS was the most reported poor outcome predictor, followed by Hughes disability score >3, a delay in independent walking, artificial ventilation, and rapid progression of symptoms. Conclusions: Despite the good prognosis of GBS in children, they could suffer long-term sequels, especially in walking abilities and gait. The axonal form is considered a crucial poor predictive factor.","PeriodicalId":43059,"journal":{"name":"Journal of Pediatrics Review","volume":" ","pages":""},"PeriodicalIF":0.3000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Pediatrics Review","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.32598/jpr.11.1.1066.1","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Guillain-Barre syndrome (GBS) is an immune-mediated polyneuropathy and a common cause of acute ascending weakness in children. Objectives: This study aims to report long-term disability and poor outcome predictors of GBS in children. Medline (via Pubmed), Embase, Cochrane Library, Web of Science, and Scopus database was searched for relevant studies until April 2022, with a designated search strategy, using MeSH terms and free keywords. Methods: Studies evaluating functional outcomes of GBS in children with at least one year of follow-up were included. All studies achieved acceptable quality for inclusion. After selecting studies based on inclusion criteria, data were extracted based on a modified standardized Joanna Briggs Institute (JBI) data extraction tool, and the methodological quality of studies were reviewed using the Joanna Briggs Institute (JBI) critical appraisal tool. Results: Fourteen studies were included in this systematic review consisting of 1141 patients (647 males, 466 females, and 28 unclassified). Follow-up duration varied from one year to 11 years. The prevalence of the GBS subtype was as follows, acute inflammatory demyelinating polyneuropathies (AIDP) 46.6%, acute motor axonal neuropathy (AMAN) 30.2%, acute motor and sensory axonal neuropathy (AMSAN) 6.8% and Miller fisher 6.1%. The most commonly reported poor outcome after at least one year of follow-up was walking disabilities and gait disorders. Motor deficits and weakness, sensory complaints, including pain or paresthesia and fatigue were other prevalent residual symptoms. Axonal form of GBS was the most reported poor outcome predictor, followed by Hughes disability score >3, a delay in independent walking, artificial ventilation, and rapid progression of symptoms. Conclusions: Despite the good prognosis of GBS in children, they could suffer long-term sequels, especially in walking abilities and gait. The axonal form is considered a crucial poor predictive factor.
背景:格林-巴利综合征(GBS)是一种免疫介导的多神经病变,是儿童急性上升无力的常见原因。目的:本研究旨在报道儿童GBS的长期残疾和不良预后预测因素。截止到2022年4月,按照指定的搜索策略,使用MeSH术语和免费关键词,对Medline(通过Pubmed)、Embase、Cochrane Library、Web of Science和Scopus数据库进行相关研究检索。方法:评估GBS儿童功能结局的研究至少随访一年。所有的研究都达到了可接受的质量。根据纳入标准选择研究后,使用改进的标准化乔安娜布里格斯研究所(JBI)数据提取工具提取数据,并使用乔安娜布里格斯研究所(JBI)关键评价工具对研究的方法学质量进行审查。结果:本系统综述纳入了14项研究,包括1141例患者(男性647例,女性466例,未分类28例)。随访时间从1年到11年不等。GBS亚型的患病率依次为:急性炎性脱髓鞘性多神经病变(AIDP) 46.6%,急性运动轴索神经病变(AMAN) 30.2%,急性运动和感觉轴索神经病变(AMSAN) 6.8%, Miller fisher 6.1%。在至少一年的随访后,最常见的不良结果是行走障碍和步态障碍。运动缺陷和虚弱,感觉主诉,包括疼痛或感觉异常和疲劳是其他常见的残留症状。轴突形式的GBS是报道最多的不良预后预测因子,其次是休斯残疾评分bb0.3,独立行走延迟,人工通气和症状快速进展。结论:尽管儿童GBS预后良好,但可能存在长期后遗症,尤其是行走能力和步态。轴突形式被认为是一个关键的、较差的预测因素。