Pediatria pre prax 2/2008

GUILLAIN-BARRÉ SYNDROME

Guillain-Barré syndrome (GBS) is an acute, progressive and ascending neuropathy characterized by weakness, paresthesias and hyporeflexia. In severe cases, muscle weakness may lead to respiratory failure. GBS is believed to result from an autoimmune response triggered by an antecedent illnes or vaccination. We divide GBS into four subtypes in term of pathophysiology. Diagnosis usually is made on clinical grounds and confirmed by lumbar puncture and liquor analysis. We use another diagnostic possibilities when the course of disease is unclear. Today the therapy of choice is immunotherapy. We administer high doses of intravenous immunoglobulins or we perform plasmapheresis. In childhood prognosis is favourable. Mortality is less than 5 %. With improvements in mechanical ventilation, dysautonomia has replaced respiratory failure as the most common cause of death.

Keywords: weakness, areflexie, proteincytologic dissociation, high dosis intravenous immunoglobulins (HDIVIG), plasmapheresis.