This evidence- and consensus-based practical guideline for the diagnosis and treatment of Guillain-Barré Syndrome (GBS) in childhood and adolescence has been developed by a group of delegates from relevant specialist societies and organisations; it is the result of an initiative by the German-Speaking Society of Neuropediatrics (GNP), and is supported by the Association of Scientific Medical Societies (AWMF, Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften). A systematic analysis of the literature revealed that only a few adequately-controlled studies exist for this particular age group, while none carries a low risk of bias. For this reason, the diagnostic and therapeutic recommendations largely rely on findings in adult patients with GBS, for which there are a higher number of suitable studies available. Consensus was established using a written, multi-step Delphi process. A high level of consensus could be reached for the crucial steps in diagnosis and treatment. We recommend basing the diagnostic approach on the clinical criteria of GBS and deriving support from CSF and electrophysiological findings. Repetition of invasive procedures that yield ambiguous results is only recommended if the diagnosis cannot be ascertained from the other criteria. For severe or persistently-progressive GBS treatment with intravenous immunoglobulin (IVIG) is recommended, whereas in cases of IVIG intolerance or inefficacy we recommended treatment with plasmapheresis. Corticosteroids are ineffective for GBS but can be considered when acute onset chronic inflammatory demyelinating polyneuropathy (A-CIDP) is suspected due to a prolonged disease course. The full German version of the Guideline is available on the AWMF website (https://www.awmf.org/leitlinien/detail/ll/022-008.html).

中文翻译：

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儿童和青少年吉兰-巴雷综合征的诊断和治疗：基于证据和共识的指南

这份基于证据和共识的儿童和青少年吉兰-巴雷综合征 (GBS) 诊断和治疗实用指南是由来自相关专业协会和组织的一组代表制定的；它是德语神经儿科学会 (GNP) 倡议的结果，并得到科学医学会协会 (AWMF, Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften) 的支持。对文献的系统分析表明，只有少数针对这一特定年龄组的充分对照研究存在，而没有一项研究具有低偏倚风险。出于这个原因，诊断和治疗建议在很大程度上依赖于成年 GBS 患者的发现，对此有更多合适的研究可用。共识是使用书面的、多步骤的 Delphi 过程建立的。可以就诊断和治疗的关键步骤达成高度共识。我们建议诊断方法基于 GBS 的临床标准，并从 CSF 和电生理结果中获得支持。仅当无法根据其他标准确定诊断时，才建议重复产生不明确结果的侵入性手术。对于严重或持续进展的 GBS，建议使用静脉免疫球蛋白 (IVIG) 进行治疗，而在 IVIG 不耐受或无效的情况下，我们建议使用血浆置换治疗。皮质类固醇对 GBS 无效，但当由于病程延长而怀疑为急性发作的慢性炎症性脱髓鞘性多发性神经病 (A-CIDP) 时，可以考虑使用皮质类固醇。