Guillain-Barré Syndrome in a Pediatric Patient with COVID-19: A Case Report and Review of Literature

Bernadette B. Terencio; Rachelle F. Patiño; Roland Dominic G. Jamora

doi:10.47895/amp.vi0.3814

Bernadette B. Terencio Neuroscience Department, College of Medicine, San Beda University, Manila, Philippines; Section of Pediatric Neurology, Department of Neurosciences, Asian Brain Institute, Asian Hospital and Medical Center, Muntinlupa, Philippines https://orcid.org/0000-0003-3309-2151
Rachelle F. Patiño Section of Pediatric Neurology, Department of Neurosciences, Asian Brain Institute, Asian Hospital and Medical Center, Muntinlupa, Philippines https://orcid.org/0000-0001-8121-9546
Roland Dominic G. Jamora Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Philippines; Institute for Neurosciences, St. Luke’s Medical Center – Quezon City and Global City, Philippines https://orcid.org/0000-0001-5317-7369

DOI: https://doi.org/10.47895/amp.vi0.3814

Keywords: COVID-19, Guillain-Barré Syndrome, polyneuropathies, pediatrics, SARS-CoV-2

Abstract

The novel coronavirus disease 2019 (COVID-19) has created a global health impact to millions of people. There
have been studies of COVID-19 patients manifesting with neurologic symptoms. Although the number of adult
COVID-19 infections diagnosed with Guillain-Barré Syndrome (GBS) is increasing, the occurrence of cases in
pediatric population remains limited or perhaps underreported. We report a rare case of an asymptomatic COVID-19 infection manifesting as acute progressive ascending polyneuropathy and hyporeflexia in a 16-year-old teen. The diagnosis of COVID-19 infection was confirmed by reverse transcription polymerase chain reaction for SARS-CoV-2 of oropharyngeal and nasopharyngeal swab specimens. Magnetic resonance imaging of the spine revealed abnormal enhancement of the cauda equina, including the dorsal and ventral roots. Electromyography and nerve conduction studies were compatible with an acute inflammatory demyelinating polyneuropathy subtype of GBS. Although lumbar puncture was not done, the clinical findings and electrodiagnostic tests were both consistent with GBS. The patient had improvement of both motor and sensory functions after completing the treatment of intravenous immunoglobulins. Neurologic manifestations of systemic illness especially in children during this time of pandemic warrants scrutiny, as these may mask a potentially dangerous and infectious ongoing COVID infection.

Author Biographies

Bernadette B. Terencio, Neuroscience Department, College of Medicine, San Beda University, Manila, Philippines; Section of Pediatric Neurology, Department of Neurosciences, Asian Brain Institute, Asian Hospital and Medical Center, Muntinlupa, Philippines

Dr. Terencio is a Neuroscience faculty of the College of Medicine of San Beda University and an active consultant of Asian Hospital and Medical Center.

Rachelle F. Patiño, Section of Pediatric Neurology, Department of Neurosciences, Asian Brain Institute, Asian Hospital and Medical Center, Muntinlupa, Philippines

Dr. Patiño is a pediatric resident of the Section of Pediatric Neurology, Department of Neurosciences, Asian Brain Institute, Asian Hospital and Medical Center, Muntinlupa, Philippines.

Roland Dominic G. Jamora, Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Philippines; Institute for Neurosciences, St. Luke’s Medical Center – Quezon City and Global City, Philippines

Dr. Jamora is a faculty of the College of Medicine and attending neurologist of the Philippine General Hospital, University of the Philippines Manila.