{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T23:16:40Z","timestamp":1773098200213,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction\/Aims<\/jats:title>\n                    <jats:p>Direct involvement of the neuromuscular junction (NMJ) in the inflammatory process of Guillain\u2013Barr\u00e9 syndrome (GBS) has been described. Despite this, the NMJ very rarely serves as a target for direct medical intervention in GBS. Here, we report the use of an acetylcholinesterase inhibitor, pyridostigmine, in four pediatric patients with axonal GBS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All patients received standard immune therapy. Pyridostigmine treatment was started 7\u2009weeks to 5\u2009months after disease onset, and 5\u201311\u2009weeks from reaching the plateau phase. Treatment efficacy was monitored by the 6\u2010min walk, quadriceps femoris and hamstring strength (manual muscle testing), the pediatric evaluation of disability inventory\u2010functional skills, and the GBS disability score. All tests were performed before and during drug intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All treated patients showed marked improvement in their motor and functional abilities. After 1\u2009month of treatment, quadriceps femoris and hamstring strength increased by at least two points, and walking distance increased by 10\u2013272\u2009m. The pediatric evaluation of disability inventory functional skills mobility test increased by 22.3\u201334.7 points. No serious side effects were documented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Pyridostigmine may be a safe and effective add\u2010on treatment in pediatric patients with axonal GBS who show insufficient response to immune therapy, and may be effectively used even at a late stage. Additional, larger studies are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mus.70153","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T10:58:50Z","timestamp":1770375530000},"page":"655-662","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pyridostigmine Treatment for Pediatric Axonal Guillain\u2013Barr\u00e9 Syndrome"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2222-5124","authenticated-orcid":false,"given":"E.","family":"Zohar\u2010Dayan","sequence":"first","affiliation":[{"name":"Pediatric Neurologic Unit Edmond and Lily Safra Children's Hospital, Chaim Sheba Medica Center, Tel Hashomer  Ramat\u2010Gan Israel"},{"name":"Sackler School of Medicine Tel\u2010Aviv University  Tel\u2010Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Landa","sequence":"additional","affiliation":[{"name":"Sackler School of Medicine Tel\u2010Aviv University  Tel\u2010Aviv Israel"},{"name":"Department of Pediatric Rehabilitation Edmond and Lily Safra Children's Hospital, Chaim Sheba Medica Center, Tel Hashomer  Ramat\u2010Gan Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0714-4798","authenticated-orcid":false,"given":"S.","family":"Barak","sequence":"additional","affiliation":[{"name":"Department of Nursing, Faculty of Health Sciences Ariel University  Ariel Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Ben\u2010Zeev","sequence":"additional","affiliation":[{"name":"Pediatric Neurologic Unit Edmond and Lily Safra Children's Hospital, Chaim Sheba Medica Center, Tel Hashomer  Ramat\u2010Gan Israel"},{"name":"Sackler School of Medicine Tel\u2010Aviv University  Tel\u2010Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0b013e328365ad3f"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1114525"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2012.05.011"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.26706"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/08820530802049996"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20104422(18)30114\u20105"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jns.12194"},{"key":"e_1_2_9_9_1","first-page":"65","article-title":"Impact of Electrophysiological and Clinical Variants, and Timing of Plasmapheresis on Outcome of Guillain\u2010Barr\u00e9 Syndrome","volume":"11","author":"Amin B.","year":"2017","journal-title":"Journal of the Association of Physicians of India"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp\u20102016\u2010314862"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nbd.2007.07.008"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.4279\u201004.2005"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.20327"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awh231"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2005.11.002"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awt285"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415\u2010017\u20108429\u20108"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2016.172"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.166.1.at1102"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/1746\u20101340\u201015\u20104"},{"key":"e_1_2_9_21_1","unstructured":"S. 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