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Yıl:2018; Cilt: 55; Sayı: 3>> Özet
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Nöropsikiyatri Arşivi; 2018;55(3):199-204
Çocukluk Çağı Guillain-Barré Sendromunda Elektrofizyolojik Alt Tipler ve Prognoz
B Konuşkan, Ç Okuyaz, B Taşdelen, SH Kurul, B Anlar
Hacettepe Üniversitesi, Ankara
Amaç: Türkiye’de 13 pediatrik nöroloji merkezine başvuran Guillain-Barré Sendromu (GBS) hastalarının klinik, epidemiyolojik, elektrofizyolojik ve prognostik özellikleri incelendi. Yöntem: Hastaların dosya kayıtlarından yaş, cinsiyet, şikayet süresi, güçsüzlük bölgeleri, kraniyal sinir tutulumu, beyin omurilik sıvısı inceleme bulguları, elektrofizyolojik bulgular, hastanede yatış süresi, mekanik ventilasyon ihtiyacı, tedavi, klinik değerlendirme puanları (başvuru, 1., 3., 6., 12. aylar ve taburculukta) kaydedildi. Bulgular: Çalışmaya 236 çocuk hasta dahil edildi. Hastaların ortalama yaşı 6.8 yıl ve kız/erkek oranı 1.3 idi. Elektrofizyolojik özelliklere göre değerlendirme yapıldığında; 84 hastada akut inflamatuar demiyelinizan poliradikülonöropati, 61 hastada akut motor aksonal nöropati, 21 hastada akut motor-duyusal aksonal nöropati tespit edildi. Kraniyal sinir tutulum oranı %16 olarak bulundu ve bu hastalarda taburculuk ve 6. ay takip klinik değerlendirme puanları anlamlı olarak daha düşüktü. Aksonal ve demiyelinizan alt tipler karşılaştırıldığında başvuru klinik skorları haricinde istatistiksel anlamlı fark saptanmadı. Sonuç: Bu çalışmada güçsüzlük süresi, hastanede yatış süreleri ve mekanik ventilasyon ihtiyacının prognozu olumsuz etkilediği, elektrofizyolojik alt tiplerin ise prognoz açısından önemli olmadığı tespit edildi.
Electrophysiological Subtypes and Prognostic Factors of Childhood Guillain-Barré Syndrome
Introduction: We assessed the clinical, epidemiologic, electrophysiological and prognostic characteristics of childhood Guillain-Barré Syndrome admitted to 13 pediatric neurology centers in Turkey. Method: Using a standard data recording form age, sex, duration of symptoms, distribution of weakness at onset, cranial nerve involvement, cerebrospinal fluid findings, electrophysiological findings, duration of hospitalization, requirement of ventilation, treatment and clinical evaluation scale at onset, discharge and 1, 3, 6, and 12 months after discharge were recorded. Results: Among the 236 children with a median age of 6.8 years there was a male to female ratio of 1.3. Based on the electrophysiological features; 84 patients were classified as acute inflammatory demyelinating polyrediculoneuropathy (AIDP), 61 as acute motor axonal neuropathy (AMAN), 21 as acute motor-sensory axonal neuropathy (AMSAN). The incidence of cranial nerve involvement was 16%, and was related to lower clinical scores at discharge and 6 months after discharge. Clinical scale scores between axonal and demyelinating subgroups did not show statistically significant difference except for admission (p

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