A CASE SERIES NEUROLOGIC CLINICAL CHARACTERISTICS, CLINICAL MANIFESTATION, AND MANAGEMENT TREATMENT OF GUILLAIN BARRE SYNDROME
Puji Mirantiningsih,Yuni Fitriana,Ratih Kusumawardani,Masdar Muid
Pediatric Department Medical Faculty of Brawijaya University Dr Saiful Anwar Hospital Malang East Java Indonesia Pediatric Departement, Medical Faculty of Brawijaya University, Dr Saiful Anwar General Hospital Malang, East Java, Indonesia
Background : We described five patients with Guillain Barre Syndrome with the same clinical manifestation with or without mechanical ventilation and different autonomic dysfunction, treatment and patient’s outcome.
Case Presentation Summary : Five cases of Guillain Barre Syndrome from 2017 to 2018 were diagnosed in Saiful Anwar Hospital. Five cases were diagnosed as GBS by clinical manifestation and EMG (Electromyography). The onset was at 4-15 years old. At admission all patients were presented with symmetrical limb weakness. In the following days, all developed a symmetrical tetraparesis. AMAN (acute motor axonal neuropathy) was the predominant subtype present in all patient from EMG examination. One patient diagnosed with GBS was at the age of 8 years old and suffered from respiratory failure. He required mechanical ventilation and he received immunoglobulin (IVIg) alone as much as 0,4 gr/kgBW/times for five days. He died during the course of the disease due to supraventricular tachycardia. One patient diagnosed with GBS was on age of 15 years old and he required mechanical ventilation because of respiratory failure. He received three times plasmapheresis alone with a good clinical response. One patient diagnosed with GBS was at the age of 8 years old and he received a combination of IVIg and one-time plasmapheresis. He died during the course of the disease due to panautonomic dysfunction. Two patients received IVIg alone for five days with a good clinical response.
Learning Points/Discussion : GBS is rare. It is important to recognize the variety and severity of the neurologic symptoms and complication associated with GBS so we can determine an appropriate diagnostic and treatment.