Acute polyneuropathy (Guillain-Barre syndrome) in children

Acute polyneuropathy, or Guillain-Barre syndrome, is an autoimmune inflammation of the peripheral and cranial nerves, with the defeat of myelin sheaths and the development of acute neuromuscular paralysis.

The causes of acute polyneuropathy (Guillain-Barre syndrome) in children

Acute polyneuropathy occurs after acute acute respiratory infection or diarrhea, as well as in allergic conditions and toxic effects. With Guillain-Barre syndrome, a bacteriological study of feces often reveals Campylobacter jejunu. The syndrome is associated with such bacterial infections as Haemophilus influenzae. Mycoplasma pneumoniae and Borrelia burgdor-fer, with cytomegaloviruses, Epstein-Barr virus, and also develops as a result of vaccination (against influenza, hepatitis C, etc.) and taking a number of medications.

Symptoms of acute polyneuropathy (Guillain-Barre syndrome) in children

With this variant of polyneuropathy, paresthesias in the fingers and toes are revealed, undefined sensitivity disorders like "stocking", ascending or simultaneously developing bilateral acute flaccid paralysis of upper and lower extremities, facial muscles and respiratory muscles with rapid development of respiratory arrest, delirious syndrome, vegetative disorders regulation, circulatory disorders in the form of fluctuations in blood pressure and bradycardia. The intensity of symptoms increases for several days, sometimes up to 4 weeks. Recovery begins 2-4 weeks after the cessation of disease progression and lasts 6-12 months.

Guillain-Barre syndrome is associated with acute inflammatory demyelinating polyneuropathy, acute motor and motosensory axonal neuropathy, as well as with Miller-Fisher syndrome, characterized by ataxia, areflexia and ophthalmoplegia.

Diagnosis of acute polyneuropathy (Guillain-Barre syndrome) in children

At the onset of the disease, body temperature changes are not observed. To make a diagnosis it is necessary to make sure that there is an increasing weakness in the upper and lower extremities, areflexia develops, vegetative dysfunction, cranial nerves are involved in the process, the protein content in the cerebrospinal fluid is high. In the dynamics of the development of the disease, no increase in sensitivity disorders is detected.

Emergency medical care for acute polyneuropathy (Guillain-Barre syndrome) in children

With Guillain-Barre syndrome, emergency intubation of the trachea, ventilation, if necessary, prescribe sedative therapy. To stop arterial hypertension, beta-blockers and sodium nitroprusside are used. In the case of arterial hypotension, intravenous infusion of rheopolyglucin is indicated, with bradycardia, the administration of atropine. Glucocorticosteroids are not used, since they do not give an effect. When necessary, the bladder is catheterized. Assign laxatives. Since the analgesic activity of NSAIDs with Guillain-Barre syndrome is not high, it is recommended to prescribe gabapentin or carbamazepine, as well as tricyclic antidepressants in combination with tramadol.

In a hospital, high doses of immunoglobulin (intrathect and ipidacrin) are intravenously administered and plasmapheresis is performed. It is necessary to prescribe sodium heparin [enoxaparin sodium, calcium supraparin (fracsiparin)]. A patient with cranial nerve damage is fed through a nasogastric tube. To prevent the development of muscle contractures, physiotherapeutic measures are shown.

[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14]