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Two Cases of Guillain-Barré Syndrome Variants Presenting With Dysautonomia

We describe 2 pediatric cases presenting with posterior reversible encephalopathy syndrome secondary to autonomic dysfunction preceding the onset of motor symptoms in Guillain-Barré syndrome variants. Patient 1 presented acutely with encephalopathy, cerebellar signs, hypertension, lower limb weaknes...

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Autores principales: Abdel-Mannan, Omar, D’Argenzio, Luigi, Pitt, Matthew, D’Arco, Felice, Bhate, Sanjay, Hacohen, Yael, Kaliakatsos, Marios
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6591518/
https://www.ncbi.nlm.nih.gov/pubmed/31259196
http://dx.doi.org/10.1177/2329048X19856778
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author Abdel-Mannan, Omar
D’Argenzio, Luigi
Pitt, Matthew
D’Arco, Felice
Bhate, Sanjay
Hacohen, Yael
Kaliakatsos, Marios
author_facet Abdel-Mannan, Omar
D’Argenzio, Luigi
Pitt, Matthew
D’Arco, Felice
Bhate, Sanjay
Hacohen, Yael
Kaliakatsos, Marios
author_sort Abdel-Mannan, Omar
collection PubMed
description We describe 2 pediatric cases presenting with posterior reversible encephalopathy syndrome secondary to autonomic dysfunction preceding the onset of motor symptoms in Guillain-Barré syndrome variants. Patient 1 presented acutely with encephalopathy, cerebellar signs, hypertension, lower limb weakness, and respiratory decompensation. Magnetic resonance imaging (MRI) brain showed occipital lesions consistent with posterior reversible encephalopathy syndrome. Nerve conduction studies were consistent with Miller-Fisher syndrome. After intravenous immunoglobulin and plasmapheresis, he improved clinically with radiological resolution. Patient 2 presented with headache, leg pain, seizures, and significant hypertension. Brain MRI was normal but spine MRI revealed enhancement of the cauda equina ventral nerve roots. She was areflexic with lower limb weakness a few days after intensive care unit admission and made a significant improvement after treatment with intravenous immunoglobulin. In children presenting with posterior reversible encephalopathy syndrome in the absent of other causes of primary hypertension, Guillain-Barré syndrome variants are an important differential etiology, presenting with autonomic dysfunction, even before signs of motor weakness become evident.
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spelling pubmed-65915182019-06-28 Two Cases of Guillain-Barré Syndrome Variants Presenting With Dysautonomia Abdel-Mannan, Omar D’Argenzio, Luigi Pitt, Matthew D’Arco, Felice Bhate, Sanjay Hacohen, Yael Kaliakatsos, Marios Child Neurol Open Original Article We describe 2 pediatric cases presenting with posterior reversible encephalopathy syndrome secondary to autonomic dysfunction preceding the onset of motor symptoms in Guillain-Barré syndrome variants. Patient 1 presented acutely with encephalopathy, cerebellar signs, hypertension, lower limb weakness, and respiratory decompensation. Magnetic resonance imaging (MRI) brain showed occipital lesions consistent with posterior reversible encephalopathy syndrome. Nerve conduction studies were consistent with Miller-Fisher syndrome. After intravenous immunoglobulin and plasmapheresis, he improved clinically with radiological resolution. Patient 2 presented with headache, leg pain, seizures, and significant hypertension. Brain MRI was normal but spine MRI revealed enhancement of the cauda equina ventral nerve roots. She was areflexic with lower limb weakness a few days after intensive care unit admission and made a significant improvement after treatment with intravenous immunoglobulin. In children presenting with posterior reversible encephalopathy syndrome in the absent of other causes of primary hypertension, Guillain-Barré syndrome variants are an important differential etiology, presenting with autonomic dysfunction, even before signs of motor weakness become evident. SAGE Publications 2019-06-16 /pmc/articles/PMC6591518/ /pubmed/31259196 http://dx.doi.org/10.1177/2329048X19856778 Text en © The Author(s) 2019 http://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Article
Abdel-Mannan, Omar
D’Argenzio, Luigi
Pitt, Matthew
D’Arco, Felice
Bhate, Sanjay
Hacohen, Yael
Kaliakatsos, Marios
Two Cases of Guillain-Barré Syndrome Variants Presenting With Dysautonomia
title Two Cases of Guillain-Barré Syndrome Variants Presenting With Dysautonomia
title_full Two Cases of Guillain-Barré Syndrome Variants Presenting With Dysautonomia
title_fullStr Two Cases of Guillain-Barré Syndrome Variants Presenting With Dysautonomia
title_full_unstemmed Two Cases of Guillain-Barré Syndrome Variants Presenting With Dysautonomia
title_short Two Cases of Guillain-Barré Syndrome Variants Presenting With Dysautonomia
title_sort two cases of guillain-barré syndrome variants presenting with dysautonomia
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6591518/
https://www.ncbi.nlm.nih.gov/pubmed/31259196
http://dx.doi.org/10.1177/2329048X19856778
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