Evaluation of the Association Among Cerebrospinal Fluid Protein, Inflammatory Markers, and Electromyography in Pediatric Guillain-Barre Syndrome

Abstract

Aim: Previous studies have shown that the cerebrospinal fluid (CSF) protein level correlates with the number of demyelination criteria in electromyography in adult patients with Guillain-Barré syndrome (GBS), which is a potentially life-threatening postinfectious disease. We aimed to assess the association between CSF protein level, inflammatory markers, and electrophysiological values in the diagnosis of pediatric patients to act quickly in treating GBS. Methods: In this cross-sectional study, thirty-nine children with GBS were retrospectively analyzed from the medical records of patients who were treated as inpatients between 2013 and 2021. Neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, C-reactive protein, uric acid, CSF protein levels, and electrophysiological parameters of the patients on admission were recorded. Hughes disability scores (HDS) were evaluated to determine the severity of disability on admission and at the 3rd month. Results: Cerebrospinal fluid protein was positively correlated with tibial and peroneal motor nerve distal latency (DL) and negatively correlated with tibial and peroneal sensorial nerve conduction velocities (NCV). In the acute inflammatory demyelinating polyneuropathy group, 3rd-month HDS was significantly lower than in the acute motor axonal neuropathy group. A positive correlation was found between first-admission HDS and 3rd-month HDS. There was no significant difference between the electrophysiological subgroups and inflammatory markers. Conclusion: In pediatric GBS patients, well-standardized ranges of the tibial and peroneal motor nerves DL, as well as medial plantar and peroneal superficial NCV, may be sensitive markers. Early rehabilitation programs could prevent disability in immobile patients.

Keywords

• child
• guillain-barre syndrome
• uric acid
• neural conduction
• medical records