Guillain–Barré syndrome with hyperreflexia and bilateral papillitis in a child

İncecik, Faruk; Hergüner, Özlem; Beşen, Şeyda; Yar, Kemal; Altunbaşak, Şakìr

doi:10.4103/1817-1745.181264

Cited by 8 publications

(7 citation statements)

References 13 publications

(16 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In 2015, a 10-year-old child with GBS developed bilateral optic neuritis during the later stages of the illness (15). Similarly, a 14-year-old male with GBS presented with hyperreflexia and bilateral papillitis (16). In the present case, the initial symptoms of GBS were binocular visual deterioration followed by the development of diplopia and ptosis, which indicated a lesion involving the bilateral oculomotor nerve.…”

Section: Discussionsupporting

confidence: 52%

Acute bilateral vision deficit as the initial symptom in Guillain‑Barre syndrome: A case report

Wen

2018

Exp Ther Med

View full text Add to dashboard Cite

Guillain-Barre syndrome (GBS) is a rare autoimmune-mediated peripheral neuropathy with an acute onset. GBS is associated with posterior cranial nerve injury including the facial, oculomotor, glossopharyngeal and vagus nerves. A 43-year-old female presented with worsening blurred binocular vision accompanied by diplopia, bilateral ptosis, speech difficulties, dysphagia, extremity numbness and weakness of the limbs. A neurological examination was conducted along with magnetic resonance imaging of the brain and spinal cord, electromyography, cerebrospinal fluid analysis and visual evoked potential tests, which led to a diagnosis of GBS. Following immunoglobulin administration, the patient's neurological deficiencies were markedly relieved and they were discharged following a 3-week observation period. To the best of our knowledge, this is the first reported case of GBS associated with cranial nerve damage presenting with bilateral visual deterioration as the initial symptom. It is necessary to emphasize that early diagnosis and commencing the immunological treatment in a timely manner resulted in a favorable prognosis for the patient.

show abstract

Section: Discussionsupporting

confidence: 52%

Acute bilateral vision deficit as the initial symptom in Guillain‑Barre syndrome: A case report

Wen

2018

Exp Ther Med

View full text Add to dashboard Cite

show abstract

“…Twenty-seven out of 45 (60 %) patients showed an axonal pattern that in 25 patients was restricted to motor fibres (the AMAN pattern) and in 2 involved motor and sensory fibres (the acute motor and sensory axonal neuropathypattern) 15 16. In five patients, all with antiganglioside antibodies, reversible conduction failure was demonstrated at follow-up studies.…”

Section: Resultsmentioning

confidence: 99%

Hyper-reflexia in Guillain-Barré syndrome: systematic review

Uncini

Notturno

Kuwabara

2020

J Neurol Neurosurg Psychiatry

View full text Add to dashboard Cite

Areflexia or hyporeflexia is a mandatory clinical criterion for the diagnosis of Guillain-Barré syndrome (GBS). A systematic review of the literature from 1 January 1993 to 30 August 2019 revealed 44 sufficiently detailed patients with GBS and hyper-reflexia, along with one we describe. 73.3% of patients were from Japan, 6.7% from the USA, 6.7% from India, 4.4% from Italy, 4.4% from Turkey, 2.2% from Switzerland and 2.2% from Slovenia, suggesting a considerable geographical variation. Hyper-reflexia was more frequently associated with antecedent diarrhoea (56%) than upper respiratory tract infection (22.2%) and the electrodiagnosis of acute motor axonal neuropathy (56%) than acute inflammatory demyelinating polyneuropathy (4.4%). Antiganglioside antibodies were positive in 89.7% of patients. Hyper-reflexia was generalised in 90.7% of patients and associated with reflex spread in half; it was present from the early progressive phase in 86.7% and disappeared in a few weeks or persisted until 18 months. Ankle clonus or Babinski signs were rarely reported (6.7%); spasticity never developed. 53.3% of patients could walk unaided at nadir, none needed mechanical ventilation or died. 92.9% of patients with limb weakness were able to walk unaided within 6 months. Electrophysiological studies showed high soleus maximal H-reflex amplitude to maximal compound muscle action potential amplitude ratio, suggestive of spinal motoneuron hyperexcitability, and increased central conduction time, suggestive of corticospinal tract involvement, although a structural damage was never demonstrated by MRI. Hyper-reflexia is not inconsistent with the GBS diagnosis and should not delay treatment. All GBS variants and subtypes can present with hyper-reflexia, and this eventuality should be mentioned in future diagnostic criteria for GBS.

show abstract

“…4,5 In the paediatric literature, there are very few case reports describing the co-occurrence of GBS and PRES. 6,7 Only a few adult case reports document the occurrence of PRES as the initial manifestation of GBS. 5,8 Our case unusually describes not only the occurrence of both diagnoses in one child but more importantly, an unusual chronology of clinical manifestations of GBS, with the initial presentation of PRES in the absence of known risk factors.…”

Section: Discussionmentioning

confidence: 99%

“…A moderate body of case reports describes their coexistence in adults, with a predominance of cases involving female adults over 55 years of age 4,5 . In the paediatric literature, there are very few case reports describing the co‐occurrence of GBS and PRES 6,7 …”

Section: Discussionmentioning

confidence: 99%