Diagnosis and management of Guillian Barre Syndrome in children and adolescents

- Clinical indicators for monitoring

1-Documentation of symptoms and signs in the medical file:

Progressive weakness of arms and legs for no more than 4 weeks..

By examination: absent or decreased deep tendon reflexes in affected limbs.

2- Electrophysiological studies (showing evidence of neuropathy) if available.

3- CSF analysis (showing cyto-albuminuous dissociation), if diagnosis is uncertain

4-  IVIg (0.4 g/kg/day for 5 days) or plasma exchange 4-5 sessions should be started if GBS-DS grade 3 or more in first 2 weeks OR  grade 2 in patients who have a fast rate of deterioration, a risk of requiring ventilatory support, swallowing difficulties, autonomic disturbances or poor prognostic factors

5- Documentation of the risk factors for requiring mechanical ventilation        

 -Rapid progression of limb weakness during hospital admission

-   GBS- DS grade 4 (unable to walk 5 m even with aid)

-  Neck flexion, facial or bulbar weakness

-   The inability to cough

-   Autonomic instability such as fluctuations in blood pressure or heart rate.

6-Single breath count (SBC) to assess any decline in respiratory function.