Ray Sanghamitra, Jain Prakash Chand
Department of Pediatrics, Cantonment General Hospital, New Delhi, India.
J Pediatr Neurosci. 2016 Oct-Dec;11(4):322-323. doi: 10.4103/1817-1745.199480.
Guillain-Barre syndrome (GBS) is the most common cause of acute flaccid paralysis worldwide both in adult and pediatric population. Although flaccid paralysis is the hallmark of this disease, there are some rare variants which may be easily missed unless suspected. Here, we present a very rare variant of GBS - acute bulbar palsy plus syndrome in a pediatric patient. A 13-year-old female child presented with right-sided lower motor neuron type of facial palsy and palsy of bilateral glossopharyngeal and vagus nerve of 2 weeks duration. On detailed neurological examination, motor and sensory system were normal, but the deep tendon reflexes were absent universally. Nerve conduction study showed demyelinating motor neuropathy. Based on typical clinical course and electrophysiological studies, the diagnosis was made. To the best of our knowledge, this is the first pediatric case of unilateral facial palsy with bulbar involvement without any motor abnormality.
吉兰-巴雷综合征（GBS）是全球成人和儿童急性弛缓性麻痹最常见的病因。尽管弛缓性麻痹是该疾病的标志，但仍有一些罕见变体，除非加以怀疑，否则很容易被漏诊。在此，我们报告1例儿科患者中极为罕见的GBS变体——急性球麻痹加综合征。一名13岁女童出现右侧下运动神经元型面神经麻痹以及双侧舌咽神经和迷走神经麻痹，病程2周。详细的神经系统检查显示，运动和感觉系统正常，但双侧腱反射均消失。神经传导研究显示为脱髓鞘性运动神经病。根据典型的临床病程和电生理研究结果做出了诊断。据我们所知，这是首例单侧面神经麻痹伴球部受累且无任何运动异常的儿科病例。
