neurojourНеврологический журнал имени Л.О. БадалянаL.O. Badalyan Neurological Journal2686-89972712-794XФГАУ «НМИЦ здоровья детей» Минздрава России10.46563/2686-8997-2024-5-4-201-217zasiuqneurojour-154Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESСиндром Гийена–Барре у детей: клинико-диагностические аспектыGuillain–Barré syndrome in children: clinical and diagnostic featureshttps://orcid.org/0000-0003-2176-1557КозыреваАнастасия АндреевнаKozyrevaAnastasia A.

Ассистент кафедры неврологии, нейрохирургии и медицинской генетики им. академика Л.О. Бадаляна Института нейронаук и нейротехнологий ФГАОУ ВО РНИМУ им. Н.И. Пирогова Минздрава России, 119571, Москва, Россия

e-mail: a.kozyreva@child-neurology.ru

Researcher at the Department of neurology, neurosurgery, and medical genetics named after Academician L.O. Badalyan, Institute of Neuroscience and Neurotechnology, Pirogov Russian National Research Medical University, Moscow, 119571, Russian Federation

e-mail: a.kozyreva@child-neurology.ru

a.kozyreva@child-neurology.ruhttps://orcid.org/0000-0002-4373-4747БембееваРаиса ЦеденкаевнаBembeevaRaisa Ts.

Доктор мед. наук, профессор кафедры неврологии, нейрохирургии и медицинской генетики им. академика Л.О. Бадаляна Института нейронаук и нейротехнологий ФГАОУ ВО РНИМУ им. Н.И. Пирогова Минздрава России, 119571, Москва, Россия

e-mail: dr.bembeeva@yandex.ru

MD, PhD, Professor in the Department of neurology, neurosurgery, and medical genetics named after Academician  L.O. Badalyan, Institute of Neuroscience and Neurotechnology, Pirogov Russian National Research Medical University, Moscow, 119571, Russian Federation

e-mail: dr.bembeeva@yandex.ru

dr.bembeeva@yandex.ruhttps://orcid.org/0000-0002-1004-992XДружининаЕвгения СергеевнаDruzhininaEugenia S.

канд. мед. наук, доцент кафедры неврологии, нейрохирургии и медицинской генетики им. академика Л.О. Бадаляна Института нейронаук и нейротехнологий ФГАОУ ВО РНИМУ им. Н.И. Пирогова Минздрава России, 119571, Москва, Россия

e-mail: naumovaes@gmail.com

MD, PhD, Associate Professor at the Department of neurology, neurosurgery, and medical genetics named after Academician L.O. Badalyan, Institute of Neuroscience and Neurotechnology, Pirogov Russian National Research Medical University, Moscow, 119571, Russian Federation

e-mail: naumovaes@gmail.com

naumovaes@gmail.comhttps://orcid.org/0000-0003-3417-3631ШакарянАрмен КареновичShakaryanArmen K.

Науч. сотр. клинического отдела ФГБНУ «ФНЦИРИП им. М. П. Чумакова РАН» (Институт полиомиелита и вирусных энцефалитов), 108819, Москва, Россия; ассистент кафедры инфекционных болезней у детей ПФ ФГАОУ ВО РНИМУ имени Н.И. Пирогова Минздрава России, 117997, Москва, Россия

e-mail: armen2@mail.ru

Researcher at the Chumakov Federal Scientific Center for Research and Development of Immune-and-Biological Products of RAS (Institute of Poliomyelitis and Viral Encephalitides), Moscow, 108819, Russian Federation; researcher at the Department of pediatric infectious diseases, Faculty of pediatrics, Pirogov Russian National Research Medical University, Moscow, 117997, Russian Federation

e-mail: armen2@mail.ru

armen2@mail.ruГусеваГалина ДмитриевнаGusevaGalina D.

Канд. мед. наук, зав. отделением нейроинфекций ГБУЗ ИКБ № 1 ДЗМ, 125367, Москва, Россия

e-mail: gusevagd@zdrav.mos.ru

MD, PhD, Head of the Neuroinfection department at the City Clinical Infectious Disease Hospital No. 1 in Moscow, Moscow, 125367, Russian Federation

e-mail: gusevagd@zdrav.mos.ru

gusevagd@zdrav.mos.ruБесединСергей ГенриховичBesedinSergey G.

Врач-невролог, ГБУЗ СК «Краевая детская клиническая больница», 355029, Ставрополь, Россия

e-mail: sergey-besedin@mail.ru

Neurologist, Stavropol Krai Children’s Clinical Hospital, Stavropol, 355029, Russian Federation

e-mail: sergey-besedin@mail.r

sergey-besedin@mail.ruЗаваденкоНиколай НиколаевичZavadenkoNikolay N.

Доктор мед. наук, профессор, зав. кафедрой неврологии, нейрохирургии и медицинской генетики им. академика Л.О. Бадаляна Института нейронаук и нейротехнологий ФГАОУ ВО РНИМУ им. Н.И. Пирогова Минздрава России, 119571, Москва, Россия

e-mail: zavadenko@mail.ru

MD, PhD, Head of the Department of neurology, neurosurgery, and medical genetics named after Academician L.O. Badalyan, Institute of Neuroscience and Neurotechnology, Pirogov Russian National Research Medical University, Moscow, 119571, Russian Federation

e-mail: zavadenko@mail.ru

zavadenko@mail.ruФГАОУ ВО «Российский национальный исследовательский медицинский университет имени Н.И. Пирогова» Минздрава России; ОСП «Российская детская клиническая больница» — филиал ФГАОУ ВО «Российский национальный исследовательский медицинский университет имени Н.И. Пирогова» Минздрава РоссииРоссияPirogov Russian National Research Medical University; Russian’s Children’s Clinical Hospital, branch of the Pirogov Russian National Research Medical UniversityRussian FederationФГБНУ «Федеральный научный центр исследований и разработки иммунобиологических препаратов имени М.П. Чумакова» РАНРоссияChumakov Federal Scientific Center for Research and Development of Immune-and-Biological Products of Russian Academy of SciencesRussian FederationГБУЗ г. Москвы «Инфекционная клиническая больница № 1» ДЗМРоссияMunicipal Clinical Infectious Disease Hospital No. 1 in MoscowRussian FederationГБУЗ СК «Краевая детская клиническая больница г. Ставрополь»РоссияStavropol Krai Children’s Clinical HospitalRussian FederationФГАОУ ВО «Российский национальный исследовательский медицинский университет имени Н.И. Пирогова» Минздрава РоссииРоссияPirogov Russian National Research Medical UniversityRussian Federation20240402202554201217Copyright © Козырева А.А., Бембеева Р.Ц., Дружинина Е.С., Шакарян А.К., Гусева Г.Д., Беседин С.Г., Заваденко Н.Н., 20252025Козырева А.А., Бембеева Р.Ц., Дружинина Е.С., Шакарян А.К., Гусева Г.Д., Беседин С.Г., Заваденко Н.Н.Kozyreva A.A., Bembeeva R.T., Druzhinina E.S., Shakaryan A.K., Guseva G.D., Besedin S.G., Zavadenko N.N.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.neuro-journal.ru/jour/article/view/154Введение

Введение. В 2025 г. исполняется 100 лет с момента описания первого случая синдрома Гийена–Барре (СГБ) у детей M. Monnier-Vinard. Хотя первоначальное описание СГБ было точным, спектр состояний, относящихся к этому диагнозу, значительно расширился, и термин стал использоваться для различных вариантов острой полинейропатии. Атипичные проявления СГБ создают сложности в диагностике для врачей.

Цель статьи — анализ демографических и клинических особенностей, методов лечения и прогноза СГБ у детей в России.

Материалы и методы

Материалы и методы. В исследование включены 50 пациентов в возрасте от 6 мес до 15 лет с типичными и атипичными формами СГБ. Неврологический статус оценивали по шкале суммарной оценки мышечной силы Medical Research Council sum score и шкале инвалидизации Хьюза. Анализировали состав ликвора, данные стимуляционной миографии, магнитно-резонансной томографии позвоночника и ультразвукового исследования периферических нервов.

Результаты

Результаты. Классический восходящий подтип СГБ был диагностирован у 30 (60%) пациентов, атипичные проявления — у 17 (34%); у 3 (6%) пациентов отмечался перекрёстный (overlap) синдром: СГБ с острым миелитом. Медиана возраста пациентов составила 7 [5,0; 11,0] лет. Обнаружены два пика заболеваемости СГБ, ассоциированные с респираторными и кишечными инфекциями. Наиболее частыми начальными симптомами были боль (80%), слабость в ногах (64%) и нарушение ходьбы (54%). Ходьбу восстановили 26 (100%) пациентов с СГБ, наблюдавшихся в течение 12 мес от дебюта заболевания.

Заключение

Заключение. У детей могут встречаться как типичные, так и атипичные формы СГБ. Перекрёстный (overlap) синдром (СГБ с острым мие­литом) является редким осложнением после COVID-19 и может быть не диагностирован. Прогноз при типичных и атипичных формах СГБ в целом благоприятен при своевременной терапии.

Соблюдение этических стандартов. Работа выполнена в рамках проведения научно-исследовательской работы «Дизиммунные полинейропатии у детей: клинико-диагностические особенности и прогноз», одобренной этическим комитетом (протокол № 192 от 27.01.2020) ФГАОУ ВО РНИМУ им. Н.И. Пирогова Минздрава России.

Участие авторов

Участие авторов:Козырева А.А. — концепция, дизайн исследования, координация исследования, сбор материала и обработка данных, обзор публикаций по теме, написание текста, редактирование статьи;Бембеева Р.Ц. — концепция и дизайн статьи, написание текста, редактирование;Дружинина Е.С. — написание текста, редактирование статьи, ультразвуковое и электрофизиологическое исследования;Шакарян А.К. — сбор материала, редактирование статьи;Гусева Г.Д. — сбор материала, редактирование статьи;Беседин С.Г. — сбор материала, редактирование статьи;Заваденко Н.Н. — концепция, дизайн исследования, координация исследования, редактирование статьи.Все соавторы — утверждение окончательного варианта статьи, ответственность за целостность всех частей статьи.

Конфликт интересов

Конфликт интересов. Авторы декларируют отсутствие явных и потенциальных конфликтов интересов в связи с публикацией данной статьи.

Финансирование

Финансирование. Исследование не имело спонсорской поддержки.

Поступила 01

Поступила 01.11.2024Принята к печати 25.11.2024Опубликована 31.01.2025

Introduction

Introduction. In 2025, we will commemorate the 100th anniversary of the first pediatric case of Guillain–Barré Syndrome (GBS), initially documented by M. Monnier-Vinard. This significant milestone invites a reevaluation of our contemporary understanding of GBS in children. While the original description of GBS was thorough, the categorization has expanded over time to include a wider array of conditions, resulting in the term applied to various acute demyelinating polyneuropathies. The atypical forms of GBS present notable diagnostic challenges for healthcare providers.

Objective

Objective. To analyze the demographic and clinical characteristics, treatment methods, and prognosis of GBS in children in Russia.

Materials and methods

Materials and methods. The study included fifty 6 months – 15 years patients with typical and atypical forms of Guillain-Barré syndrome (GBS). Neurological status was assessed using the Medical Research Council sum score and the Hughes disability scale. Additionally, data from cerebrospinal fluid analysis, nerve conduction study, magnetic resonance imaging of the spine, and peripheral nerves ultrasound was evaluated.

Results

Results. The classic ascending subtype of GBS was diagnosed in 30 (60%) patients, while atypical manifestations were observed in 17 (34%). Three (6%) patients had an overlap syndrome: GBS with acute myelitis. The median age of the patients was 7 [5.0; 11.0] years. Two peaks of GBS incidence associated with respiratory and gastrointestinal infections were identified. The most common initial symptoms were pain (80%), weakness in the legs (64%), and difficulty walking (54%). All 26 (100%) GBS patients were followed for 12 months from the onset of the disease regained the ability to walk.

Conclusion

Conclusion. Both typical and atypical forms of GBS can occur in children. Overlap syndrome (GBS with acute myelitis) is a rare complication following COVID-19 and may go undiagnosed. With appropriate therapy the prognosis for both typical and atypical forms of GBS is generally favourable.

Compliance with ethical standards. The study was conducted as part of the research project “Dysimmune Polyneuropathies in Children: Clinical and Diagnostic Features and Prognosis,” approved by the Ethics Committee (Protocol No. 192 dated January 27, 2020) of the Pirogov Russian National Research Medical University.

Contribution

Contribution:Kozyreva A.A. — concept, research design, research coordination, material collection and data processing, review of publications on the topic, text writing, article editing;Bembeeva R.Ts. — concept, research design, text writing, article editing;Druzhinina E.S. — text writing, article editing, peripheral nerve ultrasound and nerve conduction studies;Shakaryan А.К. — material collection, article editing;Guseva G.D. — material collection, article editing;Besedin S.G. — material collection, article editing;Zavadenko N.N. — concept, research design, research coordination, article editing.All co-authors are responsible for the integrity of all parts of the manuscript and approval of its final version.

Acknowledgements

Acknowledgements. The study had no sponsorship.

Conflict of interest

Conflict of interest. The authors declare no conflict of interest.

Received

Received: November 1, 2024Accepted: November 11, 2024Published: January 31, 2025

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The authors declare that there are no conflicts of interest present.