RESUMO
Guillain-Barré syndrome is clinically characterized by acute onset of generalized, symmetrical, and ascending muscle weakness and areflexia from peripheral nerve involvement. In Guillain-Barré syndrome variants, however, some patients have unusual distribution of muscle involvement. Pharyngeal-cervical-brachial variant of Guillain-Barré syndrome is characterized by oropharyngeal, neck, and upper limb muscle involvement. Although Guillain-Barré syndrome is one of several post-infectious diseases that cause limb muscle weakness, the incidence of pharyngeal-cervical-brachial variant is relatively low. Here we report the case of a 16-month-old boy who developed a rare form of Guillain-Barré syndrome, the pharyngeal-cervical-brachial variant of the disease. We concluded that taking all the other etiologic reasons into consideration, pharyngeal-cervical-brachial variant of Guillain-Barré syndrome should be remembered in patients with symptoms of bulbar and upper extremity weakness not only for early diagnosis but also to plan the treatment early and follow up the potential complications.
Assuntos
Síndrome de Guillain-Barré/fisiopatologia , Debilidade Muscular/fisiopatologia , Músculos do Pescoço/fisiopatologia , Músculos Faríngeos/fisiopatologia , Síndrome de Guillain-Barré/diagnóstico , Síndrome de Guillain-Barré/tratamento farmacológico , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Fatores Imunológicos/uso terapêutico , Lactente , Masculino , Condução NervosaRESUMO
Subacute sclerosing panencephalitis (SSPE) usually begins insidiously and follows a subacute course with relentless but slow progression to death. In recent years, however, patients with acute or fulminant course were reported. In this article, we report on three patients (2 girls, 1 boy) with SSPE who developed an acute and fulminant course. Subacute sclerosing panencephalitis may be seen with more atypical symptoms and more acute and fulminant courses due to various undetermined reasons. Early diagnosis is very important for the effectiveness of treatment. Children presenting with acute or subacute neurologic symptoms should be examined for SSPE, especially if they have no risk factors for hereditary neurodegenerative/ neurometabolic diseases, and it is more important if those children were not vaccinated or were infected with measles.
Assuntos
Panencefalite Esclerosante Subaguda/diagnóstico , Doença Aguda , Adolescente , Anticorpos Antivirais/isolamento & purificação , Antivirais/uso terapêutico , Líquido Cefalorraquidiano/imunologia , Pré-Escolar , Diagnóstico Diferencial , Eletroencefalografia , Evolução Fatal , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Vírus do Sarampo/imunologia , Exame Neurológico , Panencefalite Esclerosante Subaguda/tratamento farmacológico , Panencefalite Esclerosante Subaguda/virologiaRESUMO
Stroke etiologies in childhood differ from those in adulthood. While in children, congenital and acquired heart diseases and sickle cell anemia (SCA) are commonly seen causes, atherosclerosis is the main cause in adults. In this study, 39 children admitted to our hospital with ischemic stroke were evaluated according to etiologic factors and treatment regimens with comparison to the literature. Congenital-acquired heart disease and central nervous system infections (meningoencephalitis) were the most common causes in our series. Only one patient had dual pathology. As a result, cardiologic and infectious causes appeared to be the most important etiologic factors, especially in our region. Furthermore, etiologic factors rather than treatment used may play an important role in stroke recurrence.