Recurrence of Guillain Barré Syndrome in Patient Pediatric with Presentation of Two Different Clinical Variants

Abstract

Guillain Barré Syndrome (GBS) is an acute demyelinating polyradiculoneuropathy, with unusual heterogeneous clinical variants in pediatrics. There may be infection prior to the clinical manifestations of GBS. Establishing a diagnosis and treatment is challenging. In the present work, a 7 year old schoolgirl is presented, healthy, without risk factors, with recurrence on 2 occasions with different clinical variants of GBS. The 1st episode of GBS was 2 years old, with a history of respiratory infection. Debuting later with clinical manifestations of acute inflammatory demyelinating variant GBS. During her hospital stay, she received treatment with intravenous immunoglobulin (IVIG) (dose of 1grkg for 2 days), without respiratory and/or bulbar compromise, being discharged and sent to rehabilitation to continue multidisciplinary management. The 2nd episode of GBS was at 7 years, I presented recurrence of acute axonal motor variant GBS, secondary to respiratory infection, with acute evolution and respiratory failure, bulbar involvement, areflexia and dysautonomias, requiring mechanical ventilation for 37 days, administering IVIG of 1 grkg for 2 days). During the hospital course there was a serious neurological condition, with gradual improvement, discharging with a tracheostomy, without supplemental oxygen, tolerating the oral route and sent to neurological rehabilitation and otorhinolaryngology to reduce subsequent sequelae.