Case 11: Could This Be Guillain-Barré Syndrome?

Dana Cummings, MD, PhDPreceptor: Thomas Crawford, MD

Disclosures

February 22, 2002

In This Article

Case Presentation

A girl aged 2 years 10 months presented to the pediatric service with a history of cough, rhinorrhea, and low-grade fever of 5 days' duration. These symptoms resolved 15 days prior to admission, but the child has experienced "tired legs" for the past 12 days. Neurology was asked to see her urgently to answer the question, "Could this be Guillain-Barré syndrome (GBS)?"

Case History

Twelve days before admission, the child began crawling (instead of walking) on the playground and having difficulty climbing stairs. The next day, her left leg appeared limp, and she began a daily cycle of increasing unwillingness to walk and crying during the course of the day. Eight days before admission, her pediatrician performed plain films of her legs and back, which were reportedly unremarkable.

Seven days prior to presentation, she began walking again but with a very stiff gait. She also began to experience diarrhea, which resolved 2 days later. Five days prior to presentation, she began to crawl again; the next day, a bone scan performed at a regional children's hospital was reported as unremarkable.

Although somewhat improved, her stiff gait persists, and family members note that she is "walking like Frankenstein." At admission, the child also complains of arm pain.

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