HomePhilippine Scientific Journalvol. 53 no. 2 (2020)

Getting Better Slowly: a Case Report of Guillain-Barré Syndrome in a Pediatric Patient Presenting as Low Back Pain

Alvin G. Mariano, MD



Children with Guillain-Barré Syndrome (GBS) often do not present like adults with ascending paralysis and sensory abnormalities, but typically have pain and gait difficulties as predominant symptoms. This is a case of pediatric GBS that was not diagnosed until late in the course because of limited neurological examination and insufficient familiarity with the disorder in children. Case: A 4-year-old female was brought in due to low back pain with associated non-productive cough. She was managed as a case of pneumonia, urinary tract infection, and musculoskeletal strain. At the time of consult, she was in tolerable pain and cannot assume standing from sitting position. She had crackles on both lung fields and with direct tenderness on the lumbosacral area. Neurological examination revealed motor weakness and hyporeflexia in both upper and lower extremities. She was started with antibiotics and pain medication. Pain persisted and gait was noticed to be wobbly. She was referred to a pediatric neurologist who requested for nerve conduction velocity test which revealed symmetric sensorimotor mixed, predominantly demyelination type of polyradiculopathy for which intravenous immunoglobulin was given. Patient was subsequently discharged with improved condition. Conclusion: Pain and gait difficulties can be the main features of pediatric GBS. The initial and prominent symptom may delay the diagnosis of GBS. It is therefore important to conduct a comprehensive history and physical examination to diagnose and manage a potentially life – threatening disease.