Pseudomeningoencephalitic presentation of pediatric Guillain-Barre syndrome

Guillain-Barre syndrome is an acute, autoimmune polyradiculoneuropathy that improves with immune-modulating treatment if instituted early in the illne ss. Preliminary diagnosis relies on the clinician's recognition of the typi cal symptoms and signs as supporting evidence of the illness, such as nerve conduction studies, which may not be available emergently. We report eight children with Guillain-Barre syndrome in whom the initial presentation was atypical and suggested a primary central nervous system illness. In these patients, the predominant clinical symptoms included drowsiness, headache, irritability, and meningismus, although the classic features of Guillain-Ba rre syndrome (weakness, hyporeflexia) were also present. The atypical prese ntation caused delay in diagnosis in some cases. It is important to recogni ze this variant of pediatric Guillain-Barre syndrome to ensure expeditious diagnosis and treatment.