A case study on Guillain-Barre Syndrome and Peripheral Motor Neuropathy

Guillain-Barre Syndrome (GBS) is a post infectious polyneuropathy involving mainly motor but sometimes may also involve sensory and autonomic nerves. Weakness begins usually in the lower extremities and progressively involves the trunk, upper limbs; complete electrodiagnostic evaluation of patients with suspected Guillain-Barre syndrome requires both motor and sensory conduction studies, F response latency measurements. A 10-year-old boy sudden started felling pins-and-needles sensation, weakness, and numbness in his both upper and lower limb. On neurological examination, his cranial nerve exam was intact. His sensation was intact on both upper and lower extremities. Routine patient's laboratory studies of blood and urine gave normal results and did not reveal any infectious process. CSF elevated protein count of 220 mg/dL, with normal cell count, and an increased IgG fraction (25%). which may suspect the diagnosis of GBS. Nerve Conduction Studies showed motor conduction studies (MNCV) of the both the upper and lower extremities, revealed borderlineprolonged distal latencies, a reduced median and ulnar CMAP amplitude in upper limb ((right and left) along with reduced Common peroneal, posterior tibial in lower limb (right and left) and normal median, ulnar and sural SNAP amplitude recordings in both upper and lower limb. F response latencies were markedly prolonged and were difficult to obtain. The prognosis of GBS is dependent upon early diagnosis and intervention. The care of a GBS patient is challenging for the health care team.