title: Atypical findings of guillain-barré syndrome in children.
abstract: OBJECTIVE
  Guillain-Barre syndrome (GBS) is an immune-mediated polyneuropathy that occurs mostly after prior infection. The diagnosis of this syndrome is dependent heavily on the history and examination, although cerebrospinal ﬂuid analysis and electrodiagnostic testing usually confirm the diagnosis. This is a retrospective study which was performed to investigate the atypical features of GBS.
  
  
  METHODS
  Thirty three patients (21/63.6% males and 12/36.4% females) with GBS were retrospectively studied and prospectively evaluated at the Child Neurology institute of Mofid Children Hospital of Shahid Beheshti University of Medical Sciences between May 2011 and September 2012.
  
  
  RESULTS
  The mean age was 5.4 years (range, 1.5-10.5).Twenty one patients (87.9%) had previous history of infections. Eight patients (24.2%) admitted with atypical symptoms like upper limb weakness (3%), ptosis (3%), neck stiffness (3%), inability to stand (proximal weakness) (9.1%), headache (3%) and dysphagia (3%).According to disease process, weakness was ascending in 26 (78.8%), descending in 5 (15.2%) and static in 2 (6.1%) patients. Cranial nerve involvement was found in 8(24.3%) children, most commonly as facial palsy in 3 (9.1%).
  
  
  CONCLUSIONS
  In this study, 24.3% of our patients presented with atypical symptoms of GBS as upper limb weakness, ptosis, neck stiffness, inability to stand (proximal weakness), headache and dysphagia.
authors.affiliation: Professor of Pediatric Neurology, Pediatric Research Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran ; Professor of Pediatric Neurology, Pediatric Neurology Department, Mofid Children Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Parvaneh
authors.initials: P
authors.lastname: Karimzadeh
authors.affiliation: Fellow of Pediatric Neurology, Pediatric Neurology Research Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran.
authors.forename: Mohammad Kazem
authors.initials: MK
authors.lastname: Bakhshandeh Bali
authors.affiliation: Associate Professor of Pediatrics, Department of Pediatrics, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Mohammad Mehdi
authors.initials: MM
authors.lastname: Nasehi
authors.affiliation: General Physician, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Seyyed Mohaddeseh
authors.initials: SM
authors.lastname: Taheri Otaghsara
authors.affiliation: Professor of Pediatric Neurology, Pediatric Research Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran ; Professor of Pediatric Neurology, Pediatric Neurology Department, Mofid Children Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Ghofrani
keywords: Cerebrospinal ﬂuid; Guillain-Barre syndrome; Polyneuropathy