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Case Reports
. 2024 Dec 18;16(12):e75930.
doi: 10.7759/cureus.75930. eCollection 2024 Dec.

A Rare Pediatric Case of COVID-19-Associated Guillain-Barré Syndrome With Multiple Cranial Neuropathies and Without Pulmonary Symptoms

Yavuz Atas  1 , Serkan Kirik  2 , Hatice G Poyrazoglu  2 , Yesim Eroglu  3 , Zülal A Toraman  4
Affiliations
Case Reports

A Rare Pediatric Case of COVID-19-Associated Guillain-Barré Syndrome With Multiple Cranial Neuropathies and Without Pulmonary Symptoms

Yavuz Atas et al. Cureus. .

Abstract

Coronavirus disease (COVID-19) is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that primarily affects the respiratory system but can also lead to neurological complications such as Guillain-Barré syndrome (GBS). This case report describes an eight-year-old boy with COVID-19-associated GBS involving multiple cranial nerves (third, seventh, and ninth) without pulmonary symptoms. The patient initially presented with flu-like symptoms along with right facial paralysis, which progressed to bilateral facial paralysis, limb weakness, and sensory loss. Neurologic examination revealed a loss of deep tendon reflexes, while cerebrospinal fluid analysis showed albuminocytologic dissociation. The SARS-CoV-2 polymerase chain reaction (PCR) test was positive in the nasopharyngeal swab but negative in the cerebrospinal fluid. The patient was treated with intravenous immunoglobulin (IVIG) and showed marked improvement, regaining the ability to walk unassisted within a week. This case highlights the neuroinvasive potential of SARS-CoV-2 and demonstrates that COVID-19 in pediatric patients can be associated with neurological complications such as GBS, even without respiratory symptoms.

Keywords: cranial nerves; guillain-barré syndrome; pediatric; polyneuropathy; sars-cov-2.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Normal CT image of the chest
Figure 2
Figure 2. MRI examination of the patient at administration
Contrast-enhanced MRI findings in cauda equina and bilateral facial neuritis Fat-suppressed, contrast-enhanced sagittal T1-weighted lumbar MRI shows marked contrast enhancement of thickened nerve roots of anterior (a) and posterior (b) cauda equina (white arrows). Fat-suppressed axial T1-weighted MRI shows marked contrast enhancement of thickened nerve roots of the cauda equina (c). Contrast-enhanced coronal T1-weighted brain MRI shows enhancement consistent with bilateral facial neuritis within the bilateral internal acoustic canals (d).
Figure 3
Figure 3. The neurological examination performed at admission showed an absence of F waves (blue arrow).
See this image and copyright information in PMC

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