Dreigende respiratoire insufficiëntie bij kinderen door Guillain-Barrésyndroom

Early recognition of Guillain-Barré syndrome (GBS) is crucial to anticipate and adequately respond to possible respiratory insufficiency. Young children with GBS frequently have non-specific complaints and are more difficult to examine, which may cause a significant delay in diagnosing GBS. We present 3 children, all boys, aged 22 months, 7 years and 4 years respectively, with GBS in whom the diagnosis was missed upon admission, resulting in a failure to appreciate the risk of acute respiratory insufficiency. Two children had to undergo emergency intubation, and one of these cases had a fatal outcome. Young children with GBS often present with pain and refusal to walk, or with difficulty swallowing, and are often initially misdiagnosed with e.g. tonsillitis or coxitis. These nonspecific symptoms can be a first sign of a progressive polyradiculoneuropathy and should prompt a full neurological examination and timely referral to a paediatric neurological centre with Intensive Care facilities.