Guillain- Barre Syndrome with Ascending paralysis and Hypertension

A boy of 4 years admitted in our ward with gradual weakness of lower limbs started 5 days back with inability to stand and walk. The weakness gradually involves the upper limbs and the patient become unable to move or hold anything by his hands.

He had a history of short viral episode 7 days back
Patient is conscious but irritable, had tachycardia (pulse 130/m) and Hypertension (BP 130/85 mmHg) but the patient had no bladder or bowel involvement.

Muscle Tone and Muscle Power of the limbs were decreased. The reflexes of the limbs were absent or diminished. Sensory minimally affected.

The patient was level as Gullaine-Barre Syndrome with Ascending Paralysis and hypertension.

CBC is normal, CSF study on the 8th day showed Lymhocytes 30/cmm, Protein 145 mg/dl.

The patient was given Inj Methyl Prednisolone for 5 days. The IVIg was not available in the local market. For hypertension no specific drug was given, it came to normal on 3rd came down to normal on 3rd hospital day.

The patient now is slowly improving, his power of the upper limbs is much regained but the lower limbs is still weak and he is not able to stand or walk.

The patient is still in our ward and under our care.


Bdoza

Links : GBS-information page of National Institute of Neurological Disorders & Stroke

GBS Foundation International

Down Syndrome with truncus solitarius, cardiomegaly and severe anaemia

The girl admitted for severe pallor. She was a 7 year old girl with poor socioeconomic background. She had clinical features suggestive of Down Syndrome with facial dysmorphism, hypotonia, developmental delay and low IQ.

On examination, she was found to be severely anaemic. No clue could be identified for such a degree of anaemia. Possibility of malaria, leukemia, thalassemia were excluded clinically and by blood examinations.

There was cardiomegaly but no murmer. On Xray , lung field was translucent and there was no sign of pulmonary oedema.

Echocardiographist identified ‘truncus solitarius’ and pericardial effusion.

For pericardial effusion, we are searching for cause, tuberculosis is a possibility.

Bdoza