Atas Yavuz, Kirik Serkan, Poyrazoglu Hatice G, Eroglu Yesim, Toraman Zülal A
Department of Pediatrics, Division of Pediatric Neurology, Fırat University School of Medicine, Elazıg, TUR.
Department of Pediatrics, Division of Pediatric Neurology, Fırat University School of Medicine, Elazig, TUR.
Cureus. 2024 Dec 18;16(12):e75930. doi: 10.7759/cureus.75930. eCollection 2024 Dec.
Coronavirus disease (COVID-19) is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that primarily affects the respiratory system but can also lead to neurological complications such as Guillain-Barré syndrome (GBS). This case report describes an eight-year-old boy with COVID-19-associated GBS involving multiple cranial nerves (third, seventh, and ninth) without pulmonary symptoms. The patient initially presented with flu-like symptoms along with right facial paralysis, which progressed to bilateral facial paralysis, limb weakness, and sensory loss. Neurologic examination revealed a loss of deep tendon reflexes, while cerebrospinal fluid analysis showed albuminocytologic dissociation. The SARS-CoV-2 polymerase chain reaction (PCR) test was positive in the nasopharyngeal swab but negative in the cerebrospinal fluid. The patient was treated with intravenous immunoglobulin (IVIG) and showed marked improvement, regaining the ability to walk unassisted within a week. This case highlights the neuroinvasive potential of SARS-CoV-2 and demonstrates that COVID-19 in pediatric patients can be associated with neurological complications such as GBS, even without respiratory symptoms.
冠状病毒病（COVID-19）是一种由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的疾病，主要影响呼吸系统，但也可能导致诸如吉兰-巴雷综合征（GBS）等神经系统并发症。本病例报告描述了一名8岁男孩，患有与COVID-19相关的GBS，累及多条颅神经（第三、第七和第九对），且无肺部症状。患者最初表现为流感样症状及右侧面部麻痹，随后进展为双侧面部麻痹、肢体无力和感觉丧失。神经系统检查显示深腱反射消失，而脑脊液分析显示蛋白细胞分离。鼻咽拭子的SARS-CoV-2聚合酶链反应（PCR）检测呈阳性，但脑脊液检测呈阴性。患者接受了静脉注射免疫球蛋白（IVIG）治疗，病情明显改善，一周内恢复了独立行走能力。本病例突出了SARS-CoV-2的神经侵袭潜力，并表明儿科患者的COVID-19即使没有呼吸道症状也可能与GBS等神经系统并发症相关。
