 |
Case Report
Atypical manifestations in children with Guillain–Barré syndrome
1 Medical Sciences Course, Health Sciences School, Faculdade Ceres (FACERES), São José do Rio Preto, SP, Brazil
2 Neurosurgeon, Member of the Brazilian Society of Neurosurgery, Santa Mônica Hospital, Goiânia, GO, Brazil
3 Neurosurgeon, PhD in Neurosurgery, Member of the Brazilian Society of Neurosurgery, Professor at Santa Mônica Hospital, Goiânia, GO, Brazil
Address correspondence to:
Julia Brasileiro de Faria Cavalcante
Rua T38, 1097, Setor Bueno, apt 601, Goiânia, GO,
Brazil
Message to Corresponding Author
Article ID: 100014N06JC2020
Access full text article on other devices
Access PDF of article on other devices
How to cite this article
Cavalcante JBF, Cembraneli PN, Cavalcante RBF, Junior VFV, Cavalcante JES. Atypical manifestations in children with Guillain–Barré syndrome. Edorium J Neurol 2020;7:100014N06JC2020.ABSTRACT
Introduction: Guillain–Barré syndrome (GBS) is an acute single-phase inflammatory demyelinating polyneuropathy that occurs after an infection, characterized by a clinical pattern of acral paresthesias, ascending generalized weakness, and areflexia. Its worldwide incidence ranges from 0.5 to 1.5/100,000 children/year, predominantly males. In children, the predominant symptoms are vague paresthesias, significant, poorly localized pain, weakness manifesting as disturbance of gait, and cranial nerve abnormalities, with facial nerves most commonly affected.
Case Report: A 13-month-old female patient, crying for five days, presented with low fever, progressive, asymmetric loss of strength in lower limbs, regular general condition, tachypnea, tachycardia, hypotonia of right upper limb and left lower limb, positive Babinski sign to the right, Achilles and patellar tendon areflexia, discreet neck stiffness, hypoesthesia, and pain from the lower limbs to the xiphoid process, leading to the diagnosis of GBS. The cerebrospinal fluid did not indicate any alterations and the electroneuromyography showed reduced motor unit action potentials and normal motor conduction velocity, revealing acute motor axonal neuropathy. The patient developed respiratory arrest, requiring intensive care therapy, and orotracheal intubation. Immunoglobulin therapy was initiated and the patient gradually recovered the movements and reflexes.
Conclusion: It is very important to point out that when GBS is suspected, even if it is atypical, the patient should be admitted to the pediatric intensive care unit. This allows intensive nursing care and continuous monitoring to reduce the frequency and severity of complications.
Keywords: Asymmetry, Guillain–Barré syndrome, Paresthesia
SUPPORTING INFORMATION
Author Contributions
Julia Brasileiro de Faria Cavalcante - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Pedro Nogarotto Cembraneli - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Renata Brasileiro de Faria Cavalcante - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Volmer Fernandes Valente Junior - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
José Edison da Silva Cavalcante - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2020 Julia Brasileiro de Faria Cavalcante et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
