17 hours Ago By Steffy Thevar
Pune: A boy, aged four years and nine months, has reported a rare recurrence of the Guillain-Barré Syndrome (GBS) and is in a critical condition, his treating doctors at a private hospital said. He was first hospitalised for GBS when he was a little more than three years old and had reported weakness in the lower limbs. After treatment, it took 1.
5 years of physiotherapy for him to completely recover. In March, the boy once again got diagnosed with the syndrome. His father, a resident of Wagholi, said this is the second time in two years.
"He tested positive first in Feb 2023 after he complained of pain in his legs, and weakness. Then his respiratory muscles were not affected and hence, he did not need any ventilator support. After discharge from hospital, he required physiotherapy for almost 18 months before he could fully recover.
" But this time he is in a much serious situation, the father said. "He started showing symptoms of fever, cold, cough and weakness in the limbs by March-end. Since we were aware of these due to our previous experience, we immediately rushed him to the hospital.
He underwent a nerve conduction test that confirmed it was GBS." Neurologist Dr Bhushan Joshi, who attended to the patient, said as of now the boy is stabilising and hopefully he will be off the ventilator in another week or so and in the next few weeks he will be discharged. "The patient has a previous history of GBS, which makes this a rare case.
Except for the recent surge in Pune, this syndrome was rarely reported. So, among those affected, very few might get this syndrome again. Despite its rarity the treatment will remain the same," Dr Joshi said.
There is no known cause of recurrence of GBS, said Dr Parth Dalal, paediatric intensivist at Manipal Hospitals where the boy is undergoing treatment. "We can state clinical suspicion of GBS due to autonomic disturbance, respiratory muscle and bulbar involvement. It is confirmed with the nerve conduction velocity study showing demyelinating radiculomyelopathy and CSF studies.
We have also ruled out possible differential diagnosis like vasculitis, myocytes and metabolic causes." Dr Dalal further said the patient underwent intravenous immunoglobulin treatment cycle and is on ventilation support now. "He also underwent tracheostomy and once he is off the ventilator, which should happen in another week or so, supportive treatment like physiotherapy would start.
As of now the improvement is slow but steady in terms of limb power, respiratory muscles as he is able to maintain respiration with minimal ventilation support and he is able to gag and swallow." The child may take a long course to recover — maybe months to years, he said. "He will require long-term respiratory, chest/limb physiotherapy and psychological support.
With all these efforts, there may be full recovery or some residual weakness with other long-term effects," Dr Dalal said. As per a study published in Cureus, there is a reported 2%-3% recurrence in known GBS patients. While there is no specific known cause of GBS recurrence , the potential causes are immune system reactivation, repeated reinfections, and genetic and immunological factors, the study says.
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