Vol. 7, Issue 1, Part B (2025)

Background: Guillain-Barre syndrome (GBS) is one of the most frequent causes of acute flaccid paralysis in children, which is usually preceded by infections. There is recent evidence of a connection between GBS and central nervous system (CNS) infections (meningitis and encephalitis) in an immune-mediated manner. This study examines post-CNS infection GBS in Iraqi children investigating clinical, laboratory, and electrophysiological presentations to enhance the early identification and treatment in resource- limited settings. 
Methods: This is a retrospective observational study (January 2021-December 2023) at the Central Teaching Hospital of children, Baghdad, where patients under the age of 13 years were diagnosed with CNS infection and developed GBS during hospitalization or within 4 weeks of discharge. Recorded data were on demographics, clinical, lab, and electrodiagnostic data. Based on the criteria of CSF, CNS infections were categorized as either viral or bacterial and GBS was diagnosed according to the Brighton Level 1 standards. The treatment, outcomes, and disability scores were compared and statistically analyzed with SPSS v26. 
Results: In 26 children with CNS infection-related GBS (mean age 7.3 years), viral agents were the most common (65.4%). The average duration of time to develop GBS was 5.8 days. All were weak at the lower-limbs; 23% had acquired bulbar or respiratory problems necessitating ventilation. CSF demonstrated that 53.8 percent had an initial pleocytosis and progressive protein increase with albuminocytological dissociation. The most common subtype was AIDP (73.1%). IVIG was administered to 88.5%. Median hospitalization was 28.7 +- 12.4 days and no severe disability on discharge.
Conclusions: This study revealed a strong association between CNS infections and Guillain-Barre Syndrome in children below the age of 13. Autoimmune neuropathy can be induced by both the viral and bacterial infections through the creation of autoantibodies. Timely electrodiagnostic confirmation, early neurological assessment, serial CSF analysis, as well as early IVIG therapy enhance the prognosis which reinforces the role of clinical alertness and regular monitoring.