Postural guarding and hypertension as initial manifestations of Guillain-Barré syndrome.

A child without any prodromal events presented with incapacitating, symmetrical limb pain intensified by any movement. He lacked objective motor weakness or reflex changes. A provisional diagnosis of Guillain-Barré syndrome was not entertained despite sequential examinations that further documented dysesthesia, postural guarding, and hypertension. The clinician must consider Guillain-Barré syndrome as a cause for self-imposed immobilization associated with autonomic dysfunction.