Guillain-Barre Syndrome Manifestation with Isolated Truncal Ataxia in a Healthy 2-year old Boy: Case Report

Background: Guillain-Barre syndrome is an autoimmune disorders which affecting the peripheral nerves typically starting from distal to proximal nerves. We are reporting an A typical case presentation of Guillain-Barre syndrome.

Case presentation: 2 years old child previously healthy young boy presented with isolated truncal ataxia. His symptoms were sudden, as he had 1 episode of vomiting, followed by severe isolated truncal ataxia, and unsteady gait, with no other complaints preceded with a past history of viral upper respiratory tract infection two weeks prior to the hospital admission. A full neurological examination was done for this child, followed by a lumbar puncture, and an urgent MRI. Positive findings in the exam were +1 lower limb reflexes only, otherwise normal findings throughout. Lumbar puncture analysis showed normal proteins and glucose, with high red blood cells and minimal white blood cells. The diagnosis was made by the urgent MRI head and Spine conducted, which revealed thickening and enhancement of the cauda equina nerve roots suggestive of GBS. Accordingly, the child was admitted for 6 days, during which he received 2 doses of IVIG, and had daily occupational and physiotherapy sessions. He was discharged after much improvement, as he was able to walk again unassisted, with instructions for further physiotherapy and neurology follow ups.

Conclusion: Typical Guillain-Barre syndrome presentation is loss of power and tone starting peripherally then proximally. Unusual presentation has to be considered specially in the presence of losses of refluxes with no other warning signs of brain malignancy