Dubey Rachana, Kaushik Jaya Shankar, Israni Anil, Saini Lokesh, Patel Harsh, Chakrabarty Biswaroop, Gulati Sheffali
Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India.
Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India.
Brain Dev. 2016 Feb;38(2):250-2. doi: 10.1016/j.braindev.2015.08.004. Epub 2015 Aug 29.
Guillain Barre syndrome (GBS) commonly presents with limb weakness and occasional cranial nerve, respiratory or autonomic involvement. Isolated or predominant bilateral finger drop as presenting feature has never been reported in the pediatric age group.
A 9-year-old boy presented with deformity of both hands for 7 days and leg pain with difficulty in getting up from floor for 3 days. On examination he had bilateral clawing with subtle hip flexor weakness and hyporeflexia. His nerve conduction study revealed motor axonal neuropathy. His serum lead levels and autoimmune markers were within normal limits. His cerebrospinal fluid examination revealed albuminocytological dissociation. He was diagnosed as GBS and was given intravenous immunoglobulin. He improved completely over next 8 weeks.
GBS is one of the commonest causes of acquired neuropathy in the tropics. In resource limited setting, where electrophysiological facilities may not be available, identification of finger drop sign may help in correct management.
吉兰 - 巴雷综合征（GBS）通常表现为肢体无力，偶尔伴有颅神经、呼吸或自主神经受累。以孤立或主要表现为双侧手指下垂为特征在儿童年龄组中从未有过报道。
一名9岁男孩双手畸形7天，腿痛3天，从地上起身困难。检查发现他双侧爪形手，伴有轻微的髋屈肌无力和反射减退。他的神经传导研究显示为运动轴索性神经病。他的血清铅水平和自身免疫标志物在正常范围内。他的脑脊液检查显示蛋白细胞分离。他被诊断为GBS，并接受了静脉注射免疫球蛋白治疗。在接下来的8周内他完全康复。
GBS是热带地区获得性神经病最常见的原因之一。在资源有限的环境中，可能没有电生理设备，识别手指下垂体征可能有助于正确管理。
