Acute pharyngeal-cervical-brachial type of Guillain-Barré syndrome, masquerading brainstem stroke in a child

Abstract

Guillain-Barré syndrome (GBS) manifests clinically as an acute onset of generalized symmetrical and ascending weakness of the limb muscles with areflexia. Several variant forms of the disease with unusual distribution of muscles involvement have been described. Pharyngeal-brachial-cervical form of the disease is one of rare variants of GBS and only a few of cases have been reported in children. Here we report a 13-month-old boy, who developed acute weakness of pharyngeal, bulbar, cervical and upper limb weakness and the initial diagnostic work up were done to rule out acute brain stem stroke. We concluded that, while taking all other etiologies into consideration, pharyngeal-cervical-brachial variant of GBS should be considered in patient's symptoms with acute bulbar and upper extremity weakness in order to institute appropriate early management.

Keywords

Guillian-Barré syndrome - pharyngeal-cervical-brachial - computed tomography - magnetic resonance imaging - magnetic resonance angiography