Severity of GBS was scored on admission using (arm and leg) motor disability grading functional scale [9]. Overall disability sum score = arm disability scale (range 0–5) + leg disability scale (range 0–7); overall range: 0 (no signs of disability) to 12 (maximum disability).Clinical improvement was noted by improvement in the motor functional

PD-332991 grading scale and successful weaning (decrease of mechanical ventilator parameters) and extubation from mechanical ventilation following therapy. Management was started immediately by intravenous immunoglobulins (IVIG) in a standard dose of 400 mg/kg/day for 5 successive days. If IVIG failed to do any clinical improvement, five sessions of plasmapheresis for 5 successive days was performed using 5% albumin as replacement fluid and exchange volume 40–60 ml/kg per session. Nerve conduction studies were performed at the end of the first 2 weeks from the onset of neurologic symptoms. Nerve conduction studies that showed unclassified

results were excluded from subsequent study analysis. Motor conduction studies were performed on median, ulnar, tibial and peroneal nerves in both sides, using conventional techniques. Sensory nerve conduction studies were performed on median, ulnar and sural nerves using conventional studies. Patients were classified as having AMAN or AIDP on the basis of the electrodiagnostic criteria proposed by Ho et al. [10]. Pretreatment serum sample was taken on admission and frozen JNJ-26481585 at −80 °C until sending for antiganglioside antibodies assay. The serum IgG antibodies against gangliosides GM1, GM2, GD1a and GD1b subtypes were tested by ELISA on admission. This test is a qualitative enzyme-linked immunosorbent assay (ELIZA) for in vitro human antibodies assay in serum. When at least one for of the tested antibodies was positive (>1:500), patients were regarded as antiganglioside positive. Patients were initially grouped by positivity of antiganglioside antibodies and then by the electrodiagnoses of AIDP and AMAN. Summary

statistics were constructed using frequencies and proportions for categorical data, and means and SDs for continuous variables. We compared positive and negative groups as well as AMAN and AIDP groups using the χ2 test for categorical data, and t testes for continuous variables. P value < 0.05 was considered to be statistically significant. All statistical analysis was performed using the SPSS software program version 16 (SPSS, Chicago, USA). A total of 47 patients with GBS were admitted to the PICU within the first two weeks from the onset of neuropathy during the period of the study. There were 30 (64%) males and 17 (36%) females. The mean age was 7.272 ± 2.5 years. Thirty-six (77%) children had antecedent illness; acute respiratory infection in 13 patients (27.