Two Cases With Typical GBS And Rare GBS Variant Associated With Covid-19

Neurological symptoms in pediatric COVID-19 patients may present with severe heterogeneous central and peripheral nervous system manifestations.GBS is known to occur after infection.There are many rare variants of GBS.The Pharyngeal-cervical-brachial variant is one of them. In our study, two GBS cases with active covid-19 infection, one with typical AIDP and the other with pharyngeal-cervical-brachial GBS variant, will be presented. The first case was a previously healthy 17-year-old girl with active covid-19 infection, proven by PCR, and presented with facial, bulbar, neck and upper extremity muscle weakness and mild ptosis.Deep tendon reflexes in lower extremity normoactive upper extremity were markedly decreased.Differential diagnoses of brain stem encephalitis, myasthenia gravis and botulism were excluded due to preservation of consciousness, negative detection of myasthenic antibodies, normal sequential nerve stimulation in the EMG study, and negative botulinum toxin made from body fluid samples. IVIG treatment was applied with the diagnosis of GBS variant pharyngeal-cervical-brachial with normal magnetic-resonance-imaging, increased CSF protein, Acute motor axonal neuropathy findings in EMG and failure to obtain F latency, and clinical findings. Prognosis was not good. Second case was a 15-year-old male, active covid-19 infection in the PCR test; He had lower extremity weakness with 2/5 muscle strength, increased CSF protein, normal magnetic-resonance-graphy, and AIDP findings on EMG. IVIG treatment was applied.Prognosis was good. GBS associated with pediatric COVID-19 shows features of classic GBS. Rare variants of GBS should also be kept in mind as they may be associated with a serious disease course.
Keywords: Covid-19, child, Guillain-Barre Syndrome; pharyngeal-cervical-brachial variant