Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
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Case Report

Volume 12, Number 3, March 2021, pages 115-118

A Case Report of Guillain-Barre Syndrome in an Eleven-Month Infant


Table 1. GBS in Infants Younger Than Twelve Months of Age
AuthorEden et al, 1961 [18]Vasconcelos et al, 2012 [4]Kishore et al, 2015 [19]Akarcan et al, 2016 [20]Mishra et al, 2017 [21]
GBS: Guillain-Barre syndrome; F: female; M: male; NCV: nerve conduction velocity; CSF: cerebrospinal fluid; DPT: diphtheria-pertussis-tetanus; IVIG: intravenous immunoglobulin; PE: plasma exchange; N/D: not available; CMAP: compound motor action potential; EMG: electromyography. aIt was not considered as a triggering factor. bFourth day after IVIG.
Age (month)62572
Days of evolution255107
Trigger (Y/N)NInfluenza AH1N1aNNN
Previous immunization timeDPT 1 monthBCG and hepatitis B the first week of lifeDPT 25 daysDPT, inactivated polio, Haemophilus influenzae and pneumococcal conjugate a previous monthN/D
SymptomsCoryza, cough and fever, irritable, poor sucking, progressive hypoactivityDifficulty feeding, lethargy and gruntingCough, loose stools, breathing difficulty and listlessnessNasal discharge and coughDiarrhea and weakness of both lower limbs
Neurological examinationParalysis and flaccidity of both upper limbs, absent tendon reflexesRespiratory failure, autonomic dysfunction, symmetric distal hypotonia, absence of tendon reflexes, frog leg postureRespiratory failure, areflexia, hypotonia and reduced power in all four limbsProgressive weakness in the lower limbs and 2 days later in the arm, inability to sit and loss of head support, feeding difficulty and constipation, respiratory failureHypotonia, areflexia and absence of power in both lower limbs
CSFAlbuminocytologic dissociationAlbuminocytologic dissociationAlbuminocytologic dissociationNormalAlbuminocytologic dissociation
NCV-No motor response of the bilateral median, ulnar, fibular and posterior tibial nerves, on both sidesAbsent CMAP in both common peroneal nerves and increased distal latency, and absence of wave FDecreased amplitude of action potentialsIncreased proximal latency in lower limbs, decreased CMAP, conduction velocity in tibial and common peroneal nerves bilateral, and absence of wave F
Stool cultureNegativeNegativeNegativeNegativeNegative
TreatmentVit B1 and B12IVIG 1 g/kg/dose, 2 daysIVIG 1 g/kg/doseIVIG 1 g/kg/dose, 2 days, PE (3 sessions)b, IVIG 2 g/kg/doseIVIG 1 g/kg/dose, 2 days
Improvement2 weekTotally dependent on mechanical ventilationTracheostomy for prolonged ventilation. At 4 weeks, ventilation was withdrawn.6 weeks4 weeks