# Fulminant Form of Guillain-Barré Syndrome Complicated by Hematoma of the Corpus Callosum Occurring in the Context of Head Trauma: A Case Report

## TL;DR

A 2.5-year-old boy developed a rare and severe form of Guillain-Barré Syndrome after head trauma, requiring intensive care and highlighting the need for early diagnosis.

## Contribution

This case report presents a rare instance of Guillain-Barré Syndrome triggered by head trauma rather than infection, emphasizing diagnostic challenges in pediatric patients.

## Key findings

- The patient exhibited rapid progression to tetraplegia with sensory deficits and no fever after head trauma.
- GBS was confirmed via electroneuromyogram and responded to intravenous immunoglobulin therapy.
- The case highlights the risk of delayed diagnosis when GBS occurs alongside head trauma and respiratory failure.

## Abstract

Guillain-Barré syndrome (GBS) is an acute, demyelinating, immune-mediated polyradiculoneuropathy, often triggered by an infection. It is the most common cause of acute flaccid areflexic paralysis in children. Although generally associated with infections, this article presents a rare case with a rapid onset, where GBS was revealed following a context of head trauma. A 2.5-year-old boy, with no significant medical history, was admitted to the intensive care unit for severe acute respiratory distress, occurring 48 hours after a head trauma. Clinical examination revealed severe dyspnea without fever, and tetraparesis on admission, progressing to tetraplegia during his stay in the intensive care unit, with sensory deficit and abolished deep tendon reflexes, followed by peripheral facial diplegia. Imaging studies were normal, and cerebrospinal fluid analysis showed a characteristic albuminocytologic dissociation, typical of GBS, with no signs of meningitis. The patient required intubation and mechanical ventilation. The diagnosis of GBS was confirmed by an electroneuromyogram (ENMG), showing signs of severe sensory-motor axonal polyradiculoneuropathy. Intravenous immunoglobulin (IVIg) therapy was administered, and the patient's condition gradually improved, leading to extubation after 20 days of respiratory support. The risk factors for respiratory failure and biological markers, such as lymphopenia, are also discussed in this case report. Although GBS is a rare pediatric neurological emergency, this case illustrates how the condition can mimic other pathologies and occur in the context of head trauma, particularly in cases with axonal involvement. This can lead to a diagnostic delay. This article emphasizes the importance of early diagnosis to improve the vital prognosis and reduce the mortality associated with this potentially severe condition.