Adi Prakoso,Hadia Angriani,Urfianty ,Herry D Nawing
ilmu kesehatan anak universitas hasanuddin makassar Idai Sulawesi Selatan
Background : Guillain-Barre syndrome (GBS) is acquired polyradiculo-neuropathy, often preceded by an antecedent event. It manifests as acute flaccid weakness of the limbs, and severe generalized manifestation of respiratory failure that affects 20-30% of cases. GBS is considered monophasic illness but recurrences rate of 1-6% is documented in a subset group patients.
Case Presentation Summary : A nine-year-and-one-month-old girl came to Dr. Wahidin Sudirohusodo hospital with generalized weakness in her lower limbs since 1 day before admitted and ascended rapidly. There was history of diarrhea 2 weeks before admitted. Five months before she was admitted to hospital with generalized weakness in lower limbs and ascended with nerve conduction acute motor sensor axonal neuropathy and treated with intravenous immunoglobulin (IVIG) and made a complete recovery. On physical examination: decreased in muscle strength in both lower limbs with absent deep tendon reflexes, and negative babinsky reflex. The laboratory results: WBC 10.800/mm3, examination of cerebral fluid showed protein 124 mg/dl. Nerve conduction revealed acute motor sensor axonal neuropathy. After given corticosteroid, IVIG, ventilator support and other medication support, the condition got worsen after 2 week of medication and continued to deteriorate until she passed away.
Learning Points/Discussion : • GBS is a life-threatening polyradiculoneuropathy cause by respiratory failure, pneumonia, and autonomic dysfunction. • Recurrences is a rare entity of all GBS cases. • Early recognition and intervention can save the child. • Treatment have been developed and proved effective, but these are not sufficient in many patient.
Keywords: guillain-barre syndrome recurrent acute motor sensor axonal neuropathy
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