Neuropediatrics 2008; 39(6): 354-356
DOI: 10.1055/s-0029-1202768
Short Communication

© Georg Thieme Verlag KG Stuttgart · New York

The “Child in the Barrel Syndrome” – Severe Pharyngeal-cervical-brachial Variant of Guillain-Barre Syndrome in a Toddler

R. T. Rousseff 1 , A. J. Khuraibet 1 , D. Neubauer 2
  • 1Department of Clinical Neurophysiology, Ibn-Sina Hospital, Kuwait, Kuwait
  • 2Department of Pediatric Neurology, University Children's Hospital, University of Ljubljana, Ljubljana, Slovenia
Further Information

Publication History

received 31.10.2008

accepted 09.02.2009

Publication Date:
30 June 2009 (online)


One week after a flu-like prodrome, an 18-month-old boy developed acute severe, symmetrical, painless weakness and wasting of the shoulder girdle and upper limbs, drooling, dysphagia, dysarthria, atrophy and fasciculations of the tongue. Milder paresis involved the mimic muscles and the neck extensors. The legs were intact with brisk reflexes. The flail immobile upper limbs produced the appearance that the boy was restrained in a narrow barrel. Electrodiagnostic findings suggested demyelinating motor neuropathy sparing the legs. CSF (45 days after onset) was normal. Initial recovery was observed but 70 days after onset the child suffered severe relapse and died from respiratory arrest. This is another rare case of the pharyngeal-cervical-brachial variant of Guillain-Barre syndrome in infancy with an unusual relapsing course leading to a fatal outcome


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R. T. Rousseff

Department of Clinical Neurophysiology

Ibn-Sina Hospital

PoB 25427

13115 Kuwait

Phone: +965/663 799 70

Fax: +965/248 492 26