From the Guidelines
Intravenous immunoglobulin (IVIg) is the first-line treatment for Guillain-Barré Syndrome (GBS) in pediatric patients.
Treatment Options
- IVIg is usually administered at a dose of 0.4 g/kg body weight daily for 5 days 1, although some pediatric centers may use a dose of 2 g/kg (body weight) over 5 days 1.
- Plasma exchange is also an effective treatment, but it is not typically the first choice due to its limited availability, higher risk of complications, and greater discomfort compared to IVIg 1.
- The use of corticosteroids is not recommended as they have not shown significant benefit in treating GBS and may even have a negative effect on outcome 1.
Considerations
- In pediatric patients, IVIg is generally preferred over plasma exchange due to its ease of administration, wider availability, and lower risk of adverse events 1.
- The treatment protocol may vary depending on the clinical setting and resource availability, but IVIg remains the most widely recommended and effective treatment for GBS in pediatric patients 1.
From the Research
Treatment Options for Guillain-Barré Syndrome (GBS) in Pediatric Patients
- Intravenous immunoglobulin (IVIG) is a recommended treatment for pediatric GBS, as it appears to be equally effective as plasmapheresis and is associated with fewer complications 2.
- Plasmapheresis is also a treatment option for pediatric GBS, particularly in cases where IVIG is not effective or tolerated 3, 4.
- The "zipper method", a novel treatment strategy that combines plasma exchange and IVIG, has shown promising results in reducing mortality, speeding up weaning from mechanical ventilation, and shortening hospital stay in severe GBS patients 5.
Factors Influencing Treatment Outcome
- Axonal neuropathy, rapid progression, and severe motor weakness are significant predictors of poor response to therapy in pediatric GBS patients 3.
- The need for admission to the pediatric intensive care unit and duration of stay are lower in IVIG-treated groups compared to plasmapheresis alone 2.
Diagnosis and Treatment Guidelines
- The diagnostic approach for GBS should be based on clinical criteria, with support from CSF and electrophysiological findings 4.
- Repetition of invasive procedures that yield ambiguous results is only recommended if the diagnosis cannot be ascertained from other criteria 4.
- Corticosteroids are ineffective for GBS but can be considered when acute onset chronic inflammatory demyelinating polyneuropathy (A-CIDP) is suspected due to a prolonged disease course 4.