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On the 8th day at the hospital, he had eletromyography and nerve conduction studies which lead to the diagnosis of Guillain-Barre Syndrome (GBS). He was given a high dose of intravenous gamma globulin. He improved quickly and his pains subsided. Recovery was complete after four months.

GBS is an acquired disease believed to be from immune mediated disease of the peripheral nerves resulting to weakness and loss of reflexes. It is estimated to be about 0.4 to 1.7 cases per 100,000 population. GBS is rare in children younger than one year old.

Recently the more severe form GBS has been shown to be related to Campylobacter jenuni infection.

The main feature of GBS is progressive muscle weakness of more than one limb and reduced or absent reflexes.

Other minor features are: progression over the days to a few weeks, occurring on both sides, mild sensory loss, pain or discomfort of the extremity, cranial nerve involvement, autonomic dysfunction, no fever in the early stage, high protein in the spinal fluid, and abnormal electromyography.

Reference: Year Book of Pediatrics 2002, page 487; Pediatrics in Review, January 1997, page 10

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Leo Leonidas, MD, FAAP, Assistant Clinical Professor in Pediatrics, Tufts University School of Medicine, Boston; Attending Pediatrician, Eastern Maine Medical Center, Bangor, Maine.

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