title: [Case of a pharyngeal-cervical-brachial variant of Guillain-Barré syndrome without pharyngeal palsy].
abstract: We report a case of a 3-year-old boy with acute muscle weakness that initially affected neck and all four limbs but later vanished from the lower limbs. Pharyngeal palsy was not observed during the course. All deep tendon reflexes were absent. Peripheral nerve conduction studies showed a demyelination pattern in each limb. The patient received intravenous high-dose corticosteroid hormone, followed by two immunoglobulin therapies. His muscle strength gradually improved after treatment and was almost completely restored four months later. We ultimately diagnosed the condition as the pharyngeal-cervical-brachial variant of Guillain-Barré syndrome, in consideration of the patient's muscle weakness of the neck and four limbs, the greater degree of weakness of the upper limbs versus the lower limbs. His clinical presentation was atypical for the pharyngeal-cervical-brachial variant of Guillain-Barré syndrome, as he presented no pharyngeal muscle weakness or anti GT1a antibodies, typical manifestations of the condition.
authors.affiliation: Department of Pediatrics, Tohoku University School of Medicine, Sendai, Miyagi. yurika_hakkenseri@yahoo.co.jp
authors.forename: Yurika
authors.initials: Y
authors.lastname: Numata
authors.forename: Mitsugu
authors.initials: M
authors.lastname: Uematsu
authors.forename: Naomi
authors.initials: N
authors.lastname: Hino-Fukuyo
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Kakisaka
authors.forename: Tomoko
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Mieko
authors.initials: M
authors.lastname: Hirose
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Haginoya
authors.forename: Shigeru
authors.initials: S
authors.lastname: Tsuchiya
mesh_terms: D002675:Child, Preschool; D003711:Demyelinating Diseases; D020275:Guillain-Barre Syndrome / Q000145:classification* / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D007136:Immunoglobulins / Q000008:administration & dosage; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D009431:Neural Conduction; D010243:Paralysis; D010525:Peripheral Nerves / Q000503:physiopathology; D010614:Pharynx; D020551:Pulse Therapy, Drug; D016896:Treatment Outcome
chemical_list: D007136:Immunoglobulins; D008775:Methylprednisolone