RESUMEN
TITLE: Hemicerebelitis por chikungunya asociado a estado epiléptico refractario en edad pediátrica.
Asunto(s)
Enfermedades Cerebelosas/etiología , Fiebre Chikungunya/complicaciones , Estado Epiléptico/etiología , Enfermedad Aguda , Anticuerpos Antivirales/sangre , Anticuerpos Antivirales/líquido cefalorraquídeo , Anticonvulsivantes/uso terapéutico , Trastorno por Déficit de Atención con Hiperactividad/etiología , Déficit de la Atención y Trastornos de Conducta Disruptiva/etiología , Daño Encefálico Crónico/etiología , Enfermedades Cerebelosas/diagnóstico por imagen , Fiebre Chikungunya/sangre , Fiebre Chikungunya/líquido cefalorraquídeo , Virus Chikungunya/inmunología , Preescolar , Resistencia a Medicamentos , Disartria/etiología , Humanos , Inmunoglobulina M/sangre , Inmunoglobulina M/líquido cefalorraquídeo , Imagen por Resonancia Magnética , Masculino , Neuroimagen , Paresia/etiología , Fenobarbital/uso terapéutico , Estado Epiléptico/tratamiento farmacológicoRESUMEN
INTRODUCTION: Guillain-Barre syndrome (GBS) is an acute polyradiculoneuropathy with, in most cases, an autoimmune aetiology. It manifests as a flaccid motor paralysis, of a distal ascending type, accompanied by areflexia with or without sensory alterations. AIM: To determine the clinical and therapeutic epidemiological profile of patients diagnosed as suffering from GBS who were attended at the Benjamin Bloom Children's Hospital in El Salvador, between 1st January 1997 and 31st December 2004. PATIENTS AND METHODS: We performed an observation-based, descriptive, cross-sectional study that included 414 cases. The following data were evaluated: age distribution, sex, age, history of infections, clinical manifestations, results of the lumbar puncture, electrophysiological studies and treatment that was received. RESULTS: A predominance of males was observed, together with a more frequent presentation in school-age children. The number of cases increased in the third quarter of each of the years included in the study. The most prevalent event in the history of infections was acute respiratory infection. And the most frequent clinical presentation was ascending weakness. Albuminocytological dissociation was detected in 88% of patients who had undergone lumbar puncture. Acute inflammatory demyelinating polyneuropathy predominated in 88.3% of cases. Sixty per cent of patients had to be admitted to the intensive care unit. In most cases treatment consisted in intravenous administration of immunoglobulin. Complications occurred in 30.5% of cases and the mortality rate was 2.9%. CONCLUSIONS: GBS occurs predominantly in the rainiest season of the year, which is related to an increase in the number of infections in the upper respiratory tract and gastroenteric infections that give rise to a predisposition to present secular outbreaks of the disease.
