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. 2020 Feb;19(2):1091-1094.
doi: 10.3892/etm.2019.8311. Epub 2019 Dec 10.

Successful treatment of a 12-year-old boy with Guillain-Barré syndrome requiring tracheostomy due to respiratory muscle paralysis: A case report

Manabu Miyamoto  1 , George Imataka  1 , Go Ichikawa  1 , Yutaka Saito  2 , Takashi Kashiwagi  3 , Yoshiyuki Kaji  2 , Koji Wake  2 , Kei Funakoshi  4 , Takahide Nagashima  4 , Norito Kokubun  4 , Shigemi Yoshihara  1
Affiliations

Successful treatment of a 12-year-old boy with Guillain-Barré syndrome requiring tracheostomy due to respiratory muscle paralysis: A case report

Manabu Miyamoto et al. Exp Ther Med. 2020 Feb.

Abstract

Childhood Guillain-Barré syndrome (GBS) occasionally leads to respiratory failure early after onset, requiring long-term ventilation management after tracheal intubation. However, patients requiring tracheostomy management are rare. In the present study, a case of a 12-year-old boy with GBS who required artificial respiration management due to rapid progression of respiratory muscle paralysis is reported. Intravenous immunoglobulin (IVIg) and pulse steroid therapy were provided; however, both were ineffective and tracheostomy was necessary 26 days after onset. A second course of IVIg and pulse steroid therapy was administered on day 34. With continued rehabilitation, the patient was able to walk long distances on day 74 and was subsequently discharged on day 89. In cases of severe GBS, when IVIg and pulse steroid therapy do not improve the respiratory muscle strength of the patient, early tracheostomy may improve the patient's quality of life during artificial respiration management.

Keywords: Guillain-Barré syndrome; children; immunoglobulin; steroid pulse; tracheostomy.

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Figures

Figure 1.
Figure 1.
Clinical course of patient with GBS. GBS, Guillain-Barré syndrome; MMT, manual muscle testing; IVIg, intravenous immunoglobulin; mPSL, methylpredonisolone pulse.
See this image and copyright information in PMC

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