Carlotta Spagnoli1, Alessandro Iodice2, Grazia Gabriella Salerno2, Daniele Frattini2, Gianna Bertani2, Francesco Pisani3, Carlo Fusco2. 1. Child Neuropsychiatry Unit, Santa Maria Nuova Hospital, viale Risorgimento 80, 42123 Reggio Emilia, Italy. Electronic address: carlotta.spagnoli@asmn.re.it. 2. Child Neuropsychiatry Unit, Santa Maria Nuova Hospital, viale Risorgimento 80, 42123 Reggio Emilia, Italy. 3. Child Neuropsychiatry Unit, Neuroscience Department, University of Parma, via Gramsci 14, 43126 Parma, Italy.
Abstract
BACKGROUND: Guillain-Barré syndrome is the most frequent cause of flaccid paresis in Western countries. Moreover, CMV infection is the most common antecedent viral infection in adult patients and the presence of specific IGM antiganglioside antibodies is often identified. Instead, Guillain-Barré syndrome following CMV infections is rarely reported in childhood and often presents severe symptoms at onset and longer recovery times. MATERIAL AND METHODS: One year of clinical, electrophysiological and serological follow-up of a 9-year old child with axonal sensory-motor Guillain-Barré syndrome following CMV infection is reported. Moreover, the literature data on paediatric sensory-motor axonal GBS and GBS secondary to CMV infection and antiganglioside antibodies are reviewed. RESULTS: Our patient presented with paraesthesias and a pattern of weakness showing proximal predominance and affecting the upper limbs more than the lower limbs. At nadir, unilateral facial palsy was also present and he was unable to walk. Electroneurography showed motor-sensory axonal damage. Both anti-CMV and anti-GM2 IgM were positive. After early treatment with IVIG and IV methylprednisolone the patient recovered deambulation. Six months later, his neurological examination was normal and electroneurography showed normal data. CONCLUSION: The sensory-motor axonal form of Guillain-Barré syndrome following CMV infection may present a good prognosis and a prompt full recovery also in children, if adequate treatment is started in time.
BACKGROUND: Guillain-Barré syndrome is the most frequent cause of flaccid paresis in Western countries. Moreover, CMV infection is the most common antecedent viral infection in adult patients and the presence of specific IGM antiganglioside antibodies is often identified. Instead, Guillain-Barré syndrome following CMV infections is rarely reported in childhood and often presents severe symptoms at onset and longer recovery times. MATERIAL AND METHODS: One year of clinical, electrophysiological and serological follow-up of a 9-year old child with axonal sensory-motor Guillain-Barré syndrome following CMV infection is reported. Moreover, the literature data on paediatric sensory-motor axonal GBS and GBS secondary to CMV infection and antiganglioside antibodies are reviewed. RESULTS: Our patient presented with paraesthesias and a pattern of weakness showing proximal predominance and affecting the upper limbs more than the lower limbs. At nadir, unilateral facial palsy was also present and he was unable to walk. Electroneurography showed motor-sensory axonal damage. Both anti-CMV and anti-GM2 IgM were positive. After early treatment with IVIG and IV methylprednisolone the patient recovered deambulation. Six months later, his neurological examination was normal and electroneurography showed normal data. CONCLUSION: The sensory-motor axonal form of Guillain-Barré syndrome following CMV infection may present a good prognosis and a prompt full recovery also in children, if adequate treatment is started in time.
Authors: María P Mahecha; Ernesto Ojeda; Daniel A Vega; Juan C Sarmiento-Monroy; Juan-Manuel Anaya Journal: Immunol Res Date: 2017-02 Impact factor: 2.829
Authors: Carlotta Spagnoli; Francesco Pisani; Francesco Di Mario; Gioacchino Leandro; Federica Gaiani; Gian Luigi De' Angelis; Carlo Fusco Journal: Acta Biomed Date: 2018-12-17