An Outcome-Based Comparative Analysis Between Variants of Guillain Barre Syndrome Undergoing Plasmapheresis

Abstract

ABSTRACT: 

OBJECTIVE: To compare functional outcomes among Guillain Barre Syndrome (GBS) variants, including acute demyelinating inflammatory neuropathy (AIDP) and acute motor axonal neuropathy (AMAN) treated with Plasmapheresis. 

STUDY DESIGN: Prospective, single-center, comparative analysis 

PLACE & DURATION OF STUDY: Pediatric Neurology department and critical care unit of Children Hospital Lahore within one-year duration from January 2024 to January 2025.

MATERIALS & METHODS: All patients diagnosed with GBS who were eligible for plasmapheresis were enrolled in the study after informed consent. The outcome was measured as shifting to ICU or death due to plasmapheresis as well as functional outcome at discharge and after 3 months, compared among AIDP and AMAN variants of Guillain barre syndrome. 

RESULTS: In this study, we examined 31 cases of Guillain-Barré Syndrome (GBS). Among these, 10 cases (32.3%) were diagnosed with Acute Inflammatory Demyelinating Polyneuropathy (AIDP), while 21 cases (67.7%) were diagnosed with Acute Motor Axonal Neuropathy (AMAN). The mean age of children diagnosed with AIDP was 6.55 years (±3.97), whereas the mean age of children in the AMAN group was 8.02 years (±2.75). All children in both groups were transferred to the wards without complications (100%), and no children required ICU admission due to plasmapheresis. In the AMAN group, hypotension occurred in 2 (0.95%), urticaria in 3 (14.3%), and muscle cramps in 2 (9.5%) during plasmapheresis. In the AIDP group, 1 (10%) child experienced lightheadedness.  

CONCLUSION: Plasmapheresis is a reliable and beneficial treatment choice for pediatric Guillain-Barré Syndrome (GBS), promoting notable functional improvement in both AIDP and AMAN cases. Although AMAN was the more common subtype in our group, the outcome for both types were similar.