Guillain-Barré Syndrome Triggered by COVID-19: A Pediatric Case Report and Literature Review

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.

Clinical Profile, Follow-up, and Role of Neuroimaging in Pediatric Guillain-Barré Syndrome in the COVID Era: An Ambispective Study

“…32 A good response was noted for steroids, intravenous immunoglobulin, and plasmapheresis in 3 pediatric Guillain-Barré syndrome patients who were positive for COVID-19 RT-PCR without COVID-19 serology reports. 17,21,34…”

“…39 A systematic review by Sansone et al reported that the demyelinating variety was more common in Western countries; however, a quarter of patients had the Miller-Fisher syndrome variant of Guillain-Barré syndrome. 40 In a systematic review by Jaberi et al, 16 among the reported Guillain-Barré syndrome variants available, classic Guillain-Barré syndrome was the predominant type in 15 patients, 11,17,20,22,23,[27][28][29][31][32][33][34] Miller-Fisher syndrome variant in 4 patients, 21,25,26,30 and only 1 had polyneuritis cranialis variant. 24 In our cohort, 2 descending variants of post-COVID Guillain-Barré syndrome were diagnosed, and a similar variant was reported by Michael et al 41 in a 4-year-old Indian child in 2021.…”

“…32 A good response was noted for steroids, intravenous immunoglobulin, and plasmapheresis in 3 pediatric Guillain-Barré syndrome patients who were positive for COVID-19 RT-PCR without COVID-19 serology reports. 17,21,34 In the index study, patients with post-COVID Guillain-Barré syndrome with elevated inflammatory markers had poor responses to intravenous immunoglobulin but responded better to steroids. Therefore, in patients with elevated inflammatory markers, steroids may be helpful by causing immunosuppression and varying responsiveness.…”

“…Following this, more similar cases were reported. 12-34 Neuroimaging contributes a significant value in children with Guillain-Barré syndrome in confirming the diagnosis and excluding the differentials, especially in atypical presentations. Our study aimed to analyze the characteristics and outcomes of post-COVID Guillain-Barré syndrome in children and explored the utility of neuroimaging as an upfront diagnostic modality.…”