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September 1985

Childhood Guillain-Barré Syndrome Masquerading as a Protracted Pain Syndrome

Author Affiliations

Pediatric Neurology Unit Massachusetts General Hospital Fruit Street Boston, MA 02114

Arch Neurol. 1985;42(9):839. doi:10.1001/archneur.1985.04060080017004

To the Editor.  —Ropper and Shahani1 described pain in 29 (mostly adult) patients with Guillain-Barré syndrome (GBS). Pain preceded weakness by one to five days in four of their 29 patients. We recently observed a girl 2 years 10 months of age who had pain that preceded the onset of clinically demonstrable weakness by 19 days. During this initial period, the patient carried the presumptive diagnosis of "toxic synovitis" and it was not until the 17th day of illness that the correct diagnosis was confirmed.

Report of a Case.  —One month prior to admission, a 2-year 10-month-old girl developed a viral respiratory tract infection with positive slide test for infectious mononucleosis heterophil antibodies (Monospot) and Epstein-Barr virus titers. Two weeks later, she complained of low back, buttock, and hip pain, resisted full movements of her hips, refused to walk because of pain, and was admitted to an outside hospital with

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