Abstract
Coronavirus disease 2019 (COVID-19) has been associated with a variety of neurologic manifestations, including Guillain-Barré syndrome (GBS), but few pediatric cases have been reported. We would like to present a pediatric case of GBS in association with a recent COVID-19 infection that presented with an isolated clinical facial nerve palsy.
Highlights
The severe acute respiratory syndrome-coronavirus type 2 (SARS-CoV-2) began to appear in December of 2020
We present a case of a 2-year-old girl with a positive COVID-19 polymerase chain reaction (PCR), who presented with a left facial nerve palsy and associated imaging abnormalities and was subsequently found to have Guillain-Barré syndrome (GBS) based upon clinical and laboratory criteria
Para-infectious neuropathies may be caused by direct nerve injury from pathogen invasion or by an antibodymediated response, while post-infectious neuropathies are believed to be exclusively caused by an antibody-mediated response [3]
Summary
The severe acute respiratory syndrome-coronavirus type 2 (SARS-CoV-2) began to appear in December of 2020. COVID-19 infection has been associated with various neurologic manifestations, including stroke, meningoencephalitis, hyposmia, hypogeusia, Guillain-Barré syndrome (GBS), and cranial nerve palsies among several others [2]. Many of these complications have been documented in adult patients, but few have been reported in pediatric populations due to a limited number of documented symptomatic infections. Past medical history was notable for a COVID-19 infection with mild congestion, cough, and fatigue approximately six weeks prior to presentation, but there were no acute infectious symptoms or fever in the days leading up to presentation On initial examination, she was noted to be awake and fussy with tachycardia and elevated blood pressure. EMG/NCS findings were suggestive of a severe sub acute sensorimotor poly neuropathy with predominantly demyelinating features with secondary axonal loss, consistent with a diagnosis of GBS
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