Disclosures: Kelli N Chaviano, DO, FAAPMR: Nothing to disclose

Case Description: Patient is a 3-year-old male who presents with 2 weeks of an upper respiratory infection followed by difficulty walking and inability to stand.  Workup revealed Guillain-Barré syndrome (GBS), and he received three doses of IVIG with minimal improvement in weakness.  His clinical course declined after admission to inpatient rehab prompting acute readmission where he was treated with plasmapheresis, solumedrol, then IVIG.  EMG showed severe demyelinating and axonal sensorimotor polyneuropathy.  He was readmitted to inpatient rehabilitation where initial strength and WeeFIMs were overall worse than his previous admission.  WeeFIM scores were all total assistance and strength graded with only trace R thumb adduction and truncal movement; this decline initiated IVIG treatments for every 3 weeks.  Interventions included typical therapeutic and strengthening exercises as well as neuromuscular electrical stimulation (NMES) with functional electrical stimulation bike, Wii therapy, and body-weight supported treadmill training with Lite Gait. By discharge, he showed gains in both WeeFIM scores and strength.

Setting: Acute hospital, Inpatient rehabilitation hospital, Outpatient rehabilitation.

Patient: A 3-year-old male with newly diagnosed Guillain-Barré syndrome.

Assessment/Results: He has transitioned to outpatient physical and occupational therapies which include typical and innovative modalities such as NMES, aquatic therapy, and robotic-assisted gait training with Lokomat.  He is currently on a monthly IVIG regimen. He continues to make strength and functional gains per WeeFIMs, Gross Motor Functional Measure (GMFM), Gait Rite analysis, and Peabody tests including minimal-moderate assistance for physical and self-care as well as strength 2-3/5 UE and 3-4/5 in LE.

Discussion: Limited research evidence is available describing functional outcomes and therapeutic modalities in children with GBS. This case highlights strength and functional gains made from profound weakness using a multi-modal therapeutic approach across a continuum of care. 

Conclusion: GBS in children can be treated using a multi-modal therapeutic approach with improvement in strength and functional outcomes.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/functional-outcomes-in-a-3-year-old-with-guillain-barre-syndrome-using-a-multimodal-therapeutic-approach-across-a-continuum-of-care-a-case-report/