Acute polyneuropathies in a hospital in the south of Spain: ten years' experience

作者：Mar Alonso Montejo M; Cristina Pradillo M; Moreno Medinilla Esther E; Navas Sanchez Patricia; Martinez Anton Jacinto L

来源：Revista de Neurologia, 2017, 64(11): 502-508.

• Acute polyneuropathy
• Albuminocytologic dissociation
• Areflexia
• Guillain-Barre
• Miller Fisher
• Muscle weakness

Introduction. Guillain-Barre syndrome is the most frequent cause of acute flaccid paralysis in children.
Aim. To describe the characteristics of patients diagnosed with acute polyneuropathies and their long-term progress.
Patients and methods. We conducted a retrospective descriptive analysis of children under 14 years of age admitted to our hospital between January 2004 and December 2014. Clinical, demographic and neurophysiological variables were collected together with other imaging tests.
Results. Twenty-six patients, with a mean age of 3.83 years, were diagnosed with acute polyneuropathies, four of them of Moroccan origin. Twenty of them (76%) had a history of previous infection. The mean time elapsed since the onset of the symptoms until admission to hospital was 9.2 days, and from admission until beginning with gamma globulins it was 1.6 days. The clinical signs and symptoms prior to diagnosis were of a very heterogeneous nature. They all presented muscular weakness; 90% displayed areflexia; and 30% showed involvement of the cranial nerves. All of them (100%) received intravenous gamma globulins, and 38.4% were given systemic corticosteroids. Two patients presented chronification of the pathology. There was no mortality in the series.
Conclusions. The patients included in our study presented very unspecific symptoms in the early phases, which initially led to alternative diagnoses. To avoid this delay in the diagnosis, it is essential to perform an exhaustive physical examination that includes the myotatic reflexes and to maintain a high level of suspicion of the disease even with normal results in the complementary tests if they are performed at an early stage. We detected a greater number of cases of axonal polyneuropathy, which can possibly be explained by the high number of patients of Moroccan origin who were treated.

• 出版日期2017-6-1