Rivista di formazione e aggiornamento professionale del pediatra e del medico di base, fondata nel 1982. In collaborazione con l'Associazione Culturale Pediatri.
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La sindrome di Guillain-Barré con parestesie e diplegia facciale
Descrizione di un caso clinico

Guillain-Barré syndrome with paresthesias and facial diplegia. A case report

Cecilia Domenicali1, Carlotta Farneti1, Annamaria Magistà2, Fabrizio Pugliese2, Sara Pusceddu2, Luca Casadio2, Antonella Pini3, Federico Marchetti2
1Scuola di Specializzazione in Pediatria, Università di Ferrara
2UOC di Pediatria e Neonatologia, Ospedale di Ravenna, AUSL della Romagna
3UOC di Neuropsichiatria Infantile, IRCCS, Istituto di Scienze Neurologiche di Bologna, Ospedale di Bellaria

Dicembre 2015

Abstract
Acute bilateral facial nerve palsy is a relatively rare condition and often indicates a serious underlying medical condition. The paper reports a case of a 14-year-old girl who developed paresthesias in the distal limbs and subsequently bifacial weakness, dysphonia and dysphagia. She had had a preceding episode of upper tract respiratory infection. Neurological examination showed severe facial diplegia. Limb muscle power was preserved. Cerebrospinal fluid showed albumin cytological dissociation. Magnetic Resonance Imaging scan of the head was normal. Intravenous immunoglobulin (2 g/kg for a 5-day period) was started. The abnormal sensation in her lower limb almost disappeared, dysphonia and dysphagia rapidly improved after the second infusion. Oral steroid therapy was also added. The residual bilateral facial palsy recovered completely after 6 weeks. Bifacial weakness with paresthesias (BFP) is a subtype of Guillain-Barré syndrome and it is defined by rapidly progressive bilateral facial weakness in the absence of other cranial nerve involvement. Since this condition shows a rapid responsivity to immunogloubulins treatment, a prompt diagnosis is important.
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Bibliografia
Bibliografia Yuki N, Hartung HP. Guillain-Barré syndrome. N Engl J Med 2012;366:2294-304. Dal Verme A, Acosta P, Margan M, Pagnini C, Dellepiane E, Peralta C. Facial diplegia with atypical paresthesia. A variant of Guillain-Barré syndrome. Medicina (B Aires) 2015;75(3):178-80. Malik V, Joshi V, Green KM, Bruce IA. 15 minute consultation: a structured approach to the management of facial paralysis in a child. Arch Dis Child Educ Pract Ed 2012;97(3):82-5. Hayashi R, Yamaguchi S. Guillain-Barré syndrome variant with facial diplegia and paresthesias associated with IgM anti-GalNAc-GD1a antibodies. Intern Med 2015;54(3):345-7. Atsumi M, Kitaguchi M, Chimoto Y, et al. Ataxic Guillain-Barré syndrome with delayed facial diplegia. RinshoShinkeigaku 2003:43:548-51. Narayanan RP, James N, Ramachandran K, Jaramillo MJ. Guillain-Barré syndrome presenting with bilateral facial nerve paralysis: a case report. Cases J 2008;1(1):379. Inaloo S, Katibeh P. Guillain-Barré syndrome presenting with bilateral facial nerve palsy. Iran J Child Neurol 2014;8(1):70-2. Susuki K, Koga M, Hirata K, Isogai E, Yuki N. A Guillain-Barré syndrome variant with prominent facial diplegia. J Neurol 2009;256(11):1899-905. Takiyama Y, Sato Y, Sawada M, Nishizawa M, Nakano I, Kusunoki S. An unusual case of facial diplegia. Muscle Nerve 1999;22(6):778-9.