GUILLAIN BARRE SYNDROME, THE LEADING CAUSE OF ACUTE FLACCID PARALYSIS IN HAZARA DIVISION
Abstract
Background: Acute flaccid paralysis (AFP) can be caused by a number of conditions. A commonpreventable cause is poliomyelitis which is still being reported in Pakistan, Guillain BarreSyndrome (GBS), also known as Acute Inflammatory Demyelinating Polyneuropathy, is anothercommon cause of acute flaccid paralysis . It is important to recognize GBS in childhood as parentsconsider all acute flaccid paralysis to be due to poliomyelitis. The present study was designed toknow the frequency of different causes of acute flaccid paralysis in Hazara division. Methods :This is a retrospective analysis of cases of acute flaccid paralysis reported from various districts ofHazara division during the period January 2003 to December 2004. Acute flaccid paralysis wasdiagnosed clinically through history and clinical examination. The underlying cause of acuteflaccid paralysis was investigated by appropriate laboratory tests , such as serum electrolytes,cerebrospinal fluid analysis, electromyogram, nerve conduction study and stool culture for poliovirus and other enteroviruses . Diagnosis of Poliomyelitis was confirmed by stool testing forpoliovirus. Results: 74 patients presented with AFP during the study period. 36 were male and 38were female. Guillain Barre syndrome and enteroviral encephalopathy were the two leadingcauses of acute flaccid paralysis . Majority of the cases were reported from Mansehra district.Children of age groups 12 to 24 months and > 96 months constituted the majority (20% each).Conclusion: Guillian Barre syndrome was the leading cause of acute flaccid paralysis reportedfrom various parts of Hazara division.Key Words : Acute, Flaccid Paralysis , Guillain Barre Syndrome, Poliomyelitis .References
Alcala H. The differential diagnosis of poliomyelitis and other
acute flaccid paralyses. Bio Med Infant Mex 1993, 50(2):136-
Progress towards poliomyelitis eradication in Pakistan. Morb
Mortl Wkly Rep 2000; 49(33):758-62.
Mustafa G, Khan PA, Malik R. Poliomyelitis as an etiology of
acute flaccid paralysis and its epidemiology. J Coll Physicians
Surg Pak 1999;9(2):88-90.
Mazhar AU. Acute flaccid paralysis surveillance at Bhawalpur
Victoria Hospital sentinel unit Bhawalpur. Pakistan Ped J
; 22 (4):167-70.
Syed SSM, Solehri K, Saleem M, Nawaz MA, Sarfaraz S,
Shahzad A, Tahir M. Acute Flaccid paralysis. A review of
three years cases of District Sialkot. Pakistan J Pathol 2000;
(3):11-6.
Yoshida H, Yoneyama T, Yoshii K, Thank NH, Oanh PN,
Lien HP, Miyamura YT, Hagiwara A. Circulation of type I
wild poliovirus in Northern Vietnam during 1991-1994. Am J
Trop Med Hyg 1996; 55(5):531/5.
Tsang R S, Valdivieso-Garcia A. Pathogenesis of Guillain
syndrome. Expert Rev Anti Infec Ther 2003; 1(4) 597-608.)
Tekgul , Sardaroglu G, Tutuncuoglu S. Outcme of axonal and
demyelinating forms of Guillain-Barre syndrome in children.
Pediatr Neurol 2003;28(4):295-9.
Bull World health Organ. 1998;76(1): 55-60.
Morris Am, Elliott EJ, D’Souza RM, Antony J, Kennett M,
Longbottom H. Acute flaccid paralysis in Australian children.
J Paediatar Child Health 2003;39(1):22-6.)
Koul R, Chako A, Al- Hinai K, Zachariah M, Bulusu S, Rao
TV. A profile of childhood neuropathies at a university
hospital in Oman. Saudi Med J 2002; 23(6): 754.
Molinero MR, Varon D, Holden KR, Sladkv JT, Molina IB,
Cleaves F. Epidemiology of childhood guillain-barre
syndrome as a cause of acute flaccid paralysis in Honduras:
-1999. J Child Neurol 2003; 18(11): 741-7.
Published
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
