Dukkipati SS, Zhou DJ, Powers AM, Piccione EA, Koh S. Acute Bulbar Palsy-Plus Variant of Guillain-Barré Syndrome in a 3-Year-Old Girl.
Child Neurol Open 2022;
9:2329048X221115476. [PMID:
35936111 PMCID:
PMC9350509 DOI:
10.1177/2329048x221115476]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 06/30/2022] [Indexed: 11/17/2022] Open
Abstract
We present a case of a 3-year-old girl who rapidly developed bilateral facial
palsy, dysphagia, dysphonia, areflexia, and ataxia soon after receiving an
influenza vaccine. Brain and spine Magnetic resonance imaging (MRI) scans with
and without contrast showed enhancement of cranial nerves III, V, VII, and X, as
well as the anterior and posterior cervical spinal and cauda equina roots.
cerebrospinal fluid (CSF) studies showed white blood cell count of 19
cells/cm2, glucose 81 mg/dL, and protein 116 mg/dL, with negative
infectious and autoimmune labs. Serum IgM and IgG antibodies against GM1, GD1a,
GD1b, GM2, GT1A, GQ1b were negative. The patient was treated with intravenous
immunoglobulin, which led to a full recovery. Upon three-month follow-up, her
neurologic examination demonstrated normal cranial nerves, reflexes, and gait.
Her presentation was most consistent with the acute bulbar palsy plus (ABPp)
variant of Guillain-Barré syndrome (GBS), a rare and challenging diagnosis
especially in her age group.
Collapse