Pediatric Guillain-Barré Syndrome Presenting with Low Back Pain and Sitting Intolerance without Definite Limb Weakness -A Case Report-

Abstract

We report a case of Guillain-Barré syndrome (GBS) in a 4-year-old girl presenting with low back pain and sitting intolerance. Physical examination did not reveal limb weak-ness, but showed areflexia and bilaterally positive straight leg raising test. Lumbar spine magnetic resonance imaging (MRI) revealed enhanced nerve roots of the cauda equina. On the basis of MRI findings, we performed additional work-up including electrophysiologic, cerebrospinal fluid, and extensive laboratory studies, which confirmed the diag-nosis as GBS. She was treated with intravenous im-munoglobulin (IVIG). She did not experience any limb weak-ness or paretic gait disturbance and had complete reso-lution of back pain within two weeks after IVIG. Physicians should consider GBS as a possible diagnosis in children who have back pain only. Gadolinium-enhancement lumbar spine MRI should be recommended in children presenting with back pain and sitting intolerance in the absence of paralysis.