Living With Guillain-Barré Syndrome as Children.

Guillain-Barré Syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy that can lead to significant functional impairment. Although pediatric patients typically experience more favorable motor recovery compared to adults, emerging clinical observations suggest that psychological and sensory sequelae-such as fatigue, neuropathic pain, paresthesia, anxiety disorders, and major depressive episodes-may persist long after the acute phase.

To date, no qualitative research has specifically examined how children experience GBS and its aftermath, particularly years after recovery. The GUIREQUAL study is designed to fill this gap by using qualitative methods to explore long-term psychosocial impacts among pediatric GBS survivors, and to develop hypotheses regarding psychological vulnerability post-recovery.

This is a bicentric, prospective qualitative study conducted in two pediatric neurology centers (Toulouse and Montpellier, France). Participants will be identified from hospital records and must meet strict inclusion criteria, including a confirmed diagnosis of GBS or its variants (AIDP, AMAN, Miller Fisher), with onset 2 to 5 years prior to study enrollment. Patients with chronic inflammatory demyelinating polyneuropathy (CIDP), central nervous system involvement (e.g., Bickerstaff encephalitis), or unrelated chronic neurological/orthopedic diseases will be excluded to reduce confounding factors.

The data collection process includes:

A semi-structured, face-to-face interview (45-60 minutes) conducted during a routine follow-up visit, allowing the child (with or without parental presence, depending on age) to recount their illness experience in a supportive setting.

A brief validated screening tool to assess current depressive symptoms (CDI or BDI-FS).

A short clinical assessment by an independent clinician to evaluate any remaining physical sequelae.

Interviews will be audio-recorded, transcribed verbatim, and pseudonymized for confidentiality. Thematic reflexive analysis will be conducted following the Braun & Clarke methodology. Transcripts will be coded iteratively, and themes will be developed inductively and refined throughout the study process, in accordance with qualitative research best practices. Data collection will continue until theoretical saturation is achieved (estimated at 25 participants), ensuring the robustness of thematic conclusions.

The research team will maintain a reflexive logbook to track methodological decisions, and triangulation will be employed across multiple researchers to enhance credibility. This approach is expected to yield a nuanced understanding of how children make sense of their illness experience and what psychosocial factors may contribute to long-term well-being or distress.

Ultimately, GUIREQUAL aims to generate new clinical hypotheses, inform psychosocial follow-up strategies, and potentially advocate for early mental health screening and support in pediatric GBS survivors.

Inclusion criteria

• Children or adolescents aged 10 years or older at the time of the interview
• History of Guillain-Barré syndrome (GBS) diagnosed in childhood
• Time since acute episode: between 2 and 5 years
• Sufficient mastery of the French language to participate in a semi-structured interview
• Consent of the participant and, for minors, parental consent

Exclusion criteria

• Presence of a neurological disease other than GBS that may interfere with participation or interpretation of data
• Severe cognitive impairment preventing the child or adolescent from engaging in the interview