Pharyngeal-Cervical-Brachial Variant of Pediatric Guillain-Barre Syndrome With Antecedent Acute Hepatitis A Virus Infection

Pharyngeal-cervical-brachial weakness is considered a variant of Guillain-Barre syndrome with limited oropharyngeal, neck, and upper limb muscle involvement. The authors report on a 7-year-old boy, who developed pharyngeal-cervical-brachial type of Guillain-Barre syndrome following an antecedent episode Of acute hepatitis A virus infection, 2 weeks prior to admission. The presentation was characterized by acute onset dysphagia, loss of head control, and bilateral arm weakness. The diagnosis was confirmed by acute motor axonal changes in the arm and albumino-cytologic dissociation of the cerebrospinal fluid. The child was treated with intravenous immunoglobulin, Which resulted in gradual improvement over 3 weeks. Documented instances of this form of Guillain-Barre syndrome remain rare in the pediatric age group, with none existing following antecedent hepatitis A virus infection. The authors emphasize that acute hepatitis A virus infection be included in the triggers responsible for Guillain-Barre syndrome in children.