Diagnostic odyssey of Guillain-Barré syndrome in children

IF 1.4 4区医学 Q4 CLINICAL NEUROLOGY

Brain & Development Pub Date : 2023-10-31 DOI:10.1016/j.braindev.2023.10.004

Yoko Kobayashi Takahashi , Itaru Hayakawa , Yuichi Abe

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引用次数: 0

Abstract

Background and Objectives

A gap exists between difficulty in diagnosis and importance of early recognition and intervention in pediatric Guillain-Barré syndrome (GBS). Therefore, this study aimed to establish a diagnostic odyssey plot that allows “at-a-glance” overview of the diagnostic odyssey of GBS in children, including overall diagnostic delay, physician-related and patient-related diagnostic delays, and length and frequency of diagnostic errors.

Methods

In this single-center retrospective cohort study, standardized data were obtained from children with GBS from 2003 to 2020. Overall diagnostic delay (time between symptom onset and diagnosis), physician-related diagnostic delay (time between the first medical visit and diagnosis), and patient-related diagnostic delay (time between symptom onset and the first medical visit) were analyzed.

Results

The study examined a total of 21 patients (11 men, median age 4.5 years). Overall, there were 40 misdiagnoses among 17 patients, while four were diagnosed correctly at the first visit. The overall diagnostic delay was 9 days [interquartile range (IQR), 6–17 days]. Physician-related diagnostic delay, but not patient-related diagnostic delay, was correlated with the overall diagnostic delay. Patients in the late-diagnosed group were more frequently misdiagnosed during their diagnostic odyssey than patients in the other groups. Risk factors associated with diagnostic delay included delayed onset of weakness and sensory deficits, absence of swallowing problems, and misdiagnosis as orthopedic disorders or viral infections.

Discussion

A unique diagnostic odyssey exists in pedaitric GBS. Several clinical risk factors were associated with the diagnostic delay.

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儿童格林-巴利综合征的诊断历程。

背景和目的：儿童格林-巴利综合征（GBS）的诊断困难与早期识别和干预的重要性之间存在差距。因此，本研究旨在建立一个诊断奥德赛图，使儿童GBS的诊断奥德赛“一目了然”，包括总体诊断延迟、医生和患者相关的诊断延迟，以及诊断错误的长度和频率。方法：在这项单中心回顾性队列研究中，从2003年至2020年的GBS儿童中获得标准化数据。分析了总体诊断延迟（症状出现和诊断之间的时间）、与医生相关的诊断延迟（第一次就诊和诊断之间时间）和与患者相关的诊断延误（症状出现到第一次就诊之间时间）。结果：该研究共检查了21名患者（11名男性，中位年龄4.5岁）。总的来说，17名患者中有40人被误诊，而4人在第一次就诊时被正确诊断。总体诊断延迟为9天[四分位间距（IQR），6-17天]。与医生相关的诊断延迟，但与患者无关的诊断延迟与整体诊断延迟相关。晚期诊断组的患者在诊断过程中比其他组的患者更容易被误诊。与诊断延迟相关的风险因素包括虚弱和感觉缺陷的延迟发作、没有吞咽问题以及误诊为骨科疾病或病毒感染。讨论：在顽固性GBS中存在一种独特的诊断之旅。几个临床危险因素与诊断延迟有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Brain & Development 医学-临床神经学

CiteScore

3.60

自引率

0.00%

发文量

153

审稿时长

50 days

期刊介绍： Brain and Development (ISSN 0387-7604) is the Official Journal of the Japanese Society of Child Neurology, and is aimed to promote clinical child neurology and developmental neuroscience. The journal is devoted to publishing Review Articles, Full Length Original Papers, Case Reports and Letters to the Editor in the field of Child Neurology and related sciences. Proceedings of meetings, and professional announcements will be published at the Editor''s discretion. Letters concerning articles published in Brain and Development and other relevant issues are also welcome.