Guillain–Barré syndrome with unilateral peripheral facial paralysis in a Chinese child

Abstract

Background: Guillain-Barré syndrome (GBS) is an immune-mediated polyradiculoneuropathy with the classic presentation of acute onset neurological symptoms preceded by an infective illness, followed by progressive limb weakness. Unilateral facial paralysis is rarely seen in GBS. Case presentation:We reported a child presented with unilateral facial paralysis, limited outward movement of one eye and unilateral lower limb weakness, who was later diagnosed to have GBS. Through reviewing the patients with similar presentation reported previously, we found that the onset time of unilateral facial weakness in relation to other presentations of GBS seemed to be variable, which could be later or earlier than other symptoms, or concomitant. Most of the patients had a relatively good outcome within 2 weeks to 12 months of follow-up.Conclusions: Unilateral facial paralysis may be a feature of GBS, albeit a rare thing. Recognising the clinical patterns of such atypical variants of GBS allows for more timely and accurate diagnosis, and for treatment to be initiated without delay.

Diagnostic Pitfalls in Guillain–Barré Syndrome: Case Report and Literature Review

“…Patients may also present dysautonomia with heart-rate or blood-pressure instability, pupillary dysfunction, or even bladder or bowel dysfunction [ 31 ]. Moreover, Xue et al describe in their case report an unusual onset of GBS characterized by unilateral peripheral facial paralysis, unilateral lower-limb weakness and limited outward movement of the eye [ 56 ]. In children younger than 6 years, the manifestations of GBS can be include atypical clinical features, such as failure to bear weight, irritability, localized pain with unsteady gait, or even meningism [ 57 ].…”