Pediatric Guillain-Barré syndrome (GBS)

What is pediatric Guillain-Barré syndrome (GBS)?

Guillain-Barré syndrome is a rare type of peripheral neuropathy that causes temporary muscle weakness and paralysis. It can also temporarily paralyze chest muscles, causing potentially life-threatening breathing problems and feeding difficulties.

GBS occurs when the body’s immune system (which typically fights off germs) mistakenly attacks the peripheral nerves. These nerves on the outside (peripheral) of the brain and spinal cord control limb movements and sensations. The disease causes nerve damage (neuropathy), leading to muscle weakness and paralysis.

What are the signs and symptoms of pediatric Guillain-Barré syndrome (GBS)?

A typical sign of GBS is muscle weakness, numbness, tingling (pins-and-needle sensation) and occasionally pain, that starts in the feet and legs. These symptoms often affect both sides of the body and gradually move upward to the arms and hands. Over days or weeks, a child may develop limb paralysis.

Other symptoms include:

• Balance issues

• Breathing problems

• Difficulty climbing stairs or walking

• Facial weakness

• Irritability

• Loss of sensation in hands, feet and limbs

• Trouble chewing, swallowing and speaking

• Vision and eye problems

How is pediatric Guillain-Barré syndrome (GBS) diagnosed?

The pediatric neurologists at our GBS Center of Excellence are among the most experienced GBS specialists in Texas and the surrounding region. Our doctors use their expertise to evaluate your child’s symptoms and diagnose their condition. If needed, we perform neurological examinations.

These tests may include:

• MRI

• Lumbar puncture (spinal tap)

Up to 5% to 10% of children with GBS develop long-term muscle weakness or paralysis. Because it’s impossible to predict who will develop these chronic problems, we perform certain diagnostic tests on all children at the time of diagnosis. These tests show if there’s a problem with communication between the peripheral nerves and muscles. We’re among a select few centers in the country that takes this extra step for all children with GBS.

The information from these diagnostic tests is critical to helping our doctors plan effective treatments and monitor a child’s recovery.

The tests include:

• Electromyography (EMG) - This test tells us how well muscles respond to the nerve signals that control them.

• Nerve conduction studies - This test shows us how fast electrical impulses travel through peripheral nerves to reach muscles in the limbs.

What causes pediatric Guillain-Barré syndrome (GBS)?

GBS is an autoimmune disease, which means something causes the immune system to turn against itself. With GBS, the immune system attacks and damages the peripheral nerves. In half of all cases, GBS symptoms appear a few weeks after a child recovers from a respiratory illness like a cold or a gastrointestinal virus (stomach bug). Some children get GBS while recovering from a surgical procedure.

In rare instances, the Zika virus causes GBS. Infected mosquitos spread this virus. Zika infections in the United States are uncommon, but there have been cases in Texas. A child is more likely to become infected if they travel to warm, tropical areas where Zika-infected mosquitoes thrive.

How is pediatric Guillain-Barré syndrome (GBS) treated?

As one of only two pediatric GBS-CIDP Foundation International Centers of Excellence in Texas, we’re exceptionally well equipped to help children with GBS. We offer the latest treatments and complete care from a team of specialists, primary pediatric neurologists and neuromuscular specialists.

For most kids, GBS is temporary. As many as 9 out of 10 children fully recover. But recovery can take as long as six months to two years. Our team’s ability to quickly identify the condition and start advanced treatments helps children recover faster. Most children we treat see significant improvements within two months.

Our therapies include:

• Intravenous immunoglobulin (IVIG) - Your child receives an intravenous (IV) infusion of donated blood that contains healthy antibodies. These antibodies help stop your child’s immune system from attacking the peripheral nerves. Your child may be hospitalized for one week during this treatment.

• Plasmapheresis (plasma exchange) - For children experiencing more severe symptoms, we offer plasmapheresis (plasma exchange). A machine removes blood from your child and filters out the harmful antibodies that are attacking the nerves. The machine then returns the filtered (purified) blood back to your child. This treatment may require your child to stay at the hospital for up to two weeks.

• Rehabilitation services - Most children with GBS need intensive rehabilitation services to regain muscle strength, mobility and to improve speech, chewing and swallowing.

  • While in the hospital (and often after discharge), your child receives care from specialists at our Physical Medicine and Rehabilitation Program. These experts have deep experience working with children who have muscle weakness and GBS.

  • Children with severe symptoms may need a few weeks of inpatient rehabilitation services at Children’s Health. There your child will get much-needed intensive outpatient therapies, including physical and occupational therapy (OT).

• Pain Management - For children experiencing severe pain, we offer holistic treatments that provide relief without the use of strong pain medicines. We can show you how to ease your child’s muscle pain through massage and infused oils. When appropriate, we use pain medicines and engage the services of our pediatric pain specialists.