Guillain-Barré syndrome with hyperreflexia and bilateral papillitis in a child

Area of Science:

• Neurology
• Pediatric Neurology
• Neuroimmunology

Background:

• Guillain-Barré syndrome (GBS) is typically diagnosed by areflexia and progressive weakness.
• Areflexia is considered a hallmark for GBS diagnosis.
• Recent studies suggest variants of GBS may present with hyperreflexia.

Observation:

• A 14-year-old boy presented with symptoms suggestive of GBS.
• The patient exhibited hyperreflexia, which deviates from the typical areflexia seen in GBS.
• Bilateral papillitis was also noted as a concurrent clinical finding.

Findings:

• This case represents the first reported pediatric patient with Guillain-Barré syndrome, specifically the acute motor and sensory axonal neuropathy (AMSAN) form.
• The patient presented with both hyperreflexia and bilateral papillitis.
• This presentation challenges the established diagnostic criteria for GBS.

Implications:

• The findings suggest that hyperreflexia and papillitis can occur in pediatric GBS, particularly the AMSAN subtype.
• This case broadens the understanding of GBS clinical variability in children.
• Clinicians should consider GBS in pediatric patients with unexplained hyperreflexia and neurological signs like papillitis.