Finger drop sign: Rare presentation of a common disorder.
BACKGROUND
Guillain Barre syndrome (GBS) commonly presents with limb weakness and occasional cranial nerve, respiratory or autonomic involvement. Isolated or predominant bilateral finger drop as presenting feature has never been reported in the pediatric age group.


METHODS
A 9-year-old boy presented with deformity of both hands for 7 days and leg pain with difficulty in getting up from floor for 3 days. On examination he had bilateral clawing with subtle hip flexor weakness and hyporeflexia. His nerve conduction study revealed motor axonal neuropathy. His serum lead levels and autoimmune markers were within normal limits. His cerebrospinal fluid examination revealed albuminocytological dissociation. He was diagnosed as GBS and was given intravenous immunoglobulin. He improved completely over next 8 weeks.


CONCLUSIONS
GBS is one of the commonest causes of acquired neuropathy in the tropics. In resource limited setting, where electrophysiological facilities may not be available, identification of finger drop sign may help in correct management.
Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India.
Rachana
R
Dubey
Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India.
Jaya Shankar
JS
Kaushik
Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India.
Anil
A
Israni
Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India.
Lokesh
L
Saini
Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India.
Harsh
H
Patel
Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India.
Biswaroop
B
Chakrabarty
Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India. Electronic address: sheffalig@yahoo.com.
Sheffali
S
Gulati
D002648:Child; D005385:Fingers / Q000294:innervation / Q000503:physiopathology; D020275:Guillain-Barre Syndrome / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D008297:Male; D018908:Muscle Weakness / Q000503:physiopathology; D009431:Neural Conduction / Q000502:physiology; D009460:Neurologic Examination
Acquired neuropathy; Electrophysiology; Finger drop; GBS; Tropics