1. Pharyngeal–Cervical–Brachial variant of Guillian–Barre Syndrome in Children
- Author
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Sant K. Yadav, Shreebodh K. Yadav, and Ravi Ranjan Pradhan
- Subjects
Weakness ,Pediatrics ,medicine.medical_specialty ,gullian-barre syndrome ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,children ,Internal Medicine ,case report ,Medicine ,Botulism ,Bulbar palsy ,atypical presentation ,medicine.diagnostic_test ,business.industry ,General Engineering ,Muscle weakness ,medicine.disease ,Dysphagia ,pharyngeal-cervical-brachial variant ,Myasthenia gravis ,medicine.anatomical_structure ,Neurology ,Nerve conduction study ,Upper limb ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Guillian-Barre Syndrome (GBS) typically presents as symmetrical ascending flaccid muscle weakness with areflexia, and with or without sensory symptoms. However, some patients may present atypically, and accordingly, different variants of GBS have been reported in the literature. Pharyngeal-cervical-brachial variant is one of the rare variants and is characterized by muscle weakness extending from the oropharyngeal and neck area to the proximal upper extremities. Many physicians and neurologists are unfamiliar about pharyngeal-cervical-brachial variant, which is often misdiagnosed as brainstem stroke, myasthenia gravis or botulism. Herein, we report a case of pharyngeal-cervical-brachial variant of GBS. To the best of our knowledge, this is the first reported case of pharyngeal-cervical-brachial variant of GBS in children from Nepal. A 14-year-old Asian male presented with weakness of bilateral upper limb, dysphagia, and nasal intonation of voice. A diagnosis of pharyngeal-cervical-brachial variant of GBS was made after excluding all other possible differentials and based on cerebrospinal fluid analysis and nerve conduction study. The patient improved following conservative management. Pharyngeal-cervical-brachial variant of GBS should always be considered in any patient presenting with symmetrical upper limb weakness and bulbar palsy. This is to ensure early diagnosis, treatment, and follow-up of the potential complications.
- Published
- 2020