Upper airway dysfunction--an unusual presentation of Guillain-Barré syndrome

We report the case of a 9-year-old boy who presented to the emergency department with dysphagia, respiratory distress, hoarseness, and generalized weakness. While in the ED, his respiratory status deteriorated, and he required intubation. At that time, he was found to have normal upper airway anatomy. He was admitted to the pediatric ICU and, within 24 hours, developed areflexia and muscle weakness; he was diagnosed with Guillain-Barré syndrome. Atypical presentations of Guillain-Barré syndrome are discussed, and the necessity of considering this diagnosis when evaluating patients with evidence of cranial nerve dysfunction or upper airway distress is emphasized.