The effect of various therapies on duration of illness in children with severe Guillain-Barre syndrome (GBS) was evaluated at CHMC, Seattle, WA. Of 26 children treated in two contiguous 8-year periods, 12 received supportive care alone (SC), and 14 were treated with SC plus either plasma exchange (PE), 6 cases, or intravenous immunoglobulin (IVIg), 8 cases. Recovery to score 2 (able to walk 5 m without support) was similar in the SC and IVIg groups, with a nonsignificant trend toward longer recovery times in the PE group. The addition of PE or IVIg did not improve outcome or shorten duration of illness compared with SC alone. Full recovery occurred in almost all patients within 6 months of disease onset. 
COMMENT. Immunotherapy in severe pediatric GBS does not improve outcome or shorten duration of illness compared with supportive care alone and may be less effective than in adult cases of GBS.