Guillain–Barre syndrome in southern Chinese children: 32 year experience in Hong Kong

Background:  The purpose of the present study was to investigate the clinical pattern of Guillain–Barre syndrome (GBS) in southern Chinese children in Hong Kong and to compare the clinical outcome of early versus delayed intervention with i.v. immunoglobulin (IVIg). Methods:  A retrospective review of medical records of GBS patients admitted to two hospitals on Hong Kong Island during a 32 year period (1976–2008) was performed. Clinical outcome was compared for early versus late IVIg treatment, using a 7 day cut-off. This analysis was then repeated using a 10 day cut-off. Results:  Of 34 children, 22 (65%) had preceding illness but no infective etiology could be identified. Nerve conduction was measured in 17 (50%): nine had demyelinating neuropathy, three had axonal neuropathy with demyelinating features, two had pure axonal neuropathy, and one was normal. In two patients with Miller-Fisher syndrome (MFS) the studies showed additional abnormal sensory conduction. Twenty-one received conservative treatment only. Ten (29%) received IVIg, two (6%) received plasmapheresis and three (9%) received corticosteroid. Thirty-one (91%) had complete recovery, two (6%) had long-term morbidity and one died of respiratory failure. Comparison of the early and late IVIg treatment groups for each cut-off showed no statistically significant difference in clinical outcome. A longer period of hospital stay and longer time to improve one disability grade, however, were noted for the late treatment group for both cut-offs. Conclusions:  The clinical profile of GBS in southern Chinese children in Hong Kong is provided. There was no statistically significant difference between early versus delayed treatment with IVIg.