Journal of Pediatric Neurosciences
: 2017  |  Volume : 12  |  Issue : 4  |  Page : 398--399

Cranial nerve involvement in Guillain–Barre syndrome: Revisited

Khichar Purnaram Shubhakaran 
 Department of Neurology, Dr. S. N. Medical College, Jodhpur, Rajasthan, India

Correspondence Address:
Dr. Khichar Purnaram Shubhakaran
House No. E-22/13, Umaid Hospital Campus, Jodhpur - 342 001, Rajasthan

How to cite this article:
Shubhakaran KP. Cranial nerve involvement in Guillain–Barre syndrome: Revisited.J Pediatr Neurosci 2017;12:398-399

How to cite this URL:
Shubhakaran KP. Cranial nerve involvement in Guillain–Barre syndrome: Revisited. J Pediatr Neurosci [serial online] 2017 [cited 2022 Aug 9 ];12:398-399
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Full Text

Dear Sir,

We read an interesting case report by Ray and Jain.[1] The eminent authors have reported a case of Guillain–Barre Syndrome (GBS) presenting as bulbar palsy plus syndrome. Here, we would like to share our experience and views:

Cranial nerve involvement is said to be rare (5%), especially in children by the authors[1] and supported by another reference.[2] We in a prospective study of 61 patients in the age range of 8–78 years, found bulbar palsy in 46.2%, facial palsy in 46%, tongue weakness in 10%, unilateral facial palsy in (3 patients) 5%, ophthalmoplegia in 6.4%, and sensorineural deafness (eighth cranial nerve involvement) in 1 patient.[3] Our observations are almost similar to the earlier text references[4]

The authors have said that unilateral facial palsy in GBS is extremely rare, especially in children. We in our study which also included pediatric population found unilateral facial palsy in (three patients) 5% of the patients[3]

The present study also concluded that there is a correlation between cranial nerve palsy and severity of GBS, and bulbar palsy is an indicator of respiratory involvement. Careful search of the cranial nerve involvement may yield more and more cranial neuropathies[3]

As bulbar involvement is an indicator of impending respiratory involvement, the index case of the eminent authors was lucky enough not have such complication. One reason may be that the patient’s illness stabilized after initial progression for 4 days.

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1Ray S, Jain PC. Acute bulbar palsy plus syndrome: A rare variant of Guillain-Barre syndrome. J Pediatr Neurosci 2016;11:322-3.
2Lin JJ, Hsia SH, Wang HS, Lyu RK, Chou ML, Hung PC, et al. Clinical variants of Guillain-Barré syndrome in children. Pediatr Neurol 2012;47:91-6.
3Bhargava A, Banakar BF, Pujar GS, Khichar S. A study of Guillain-Barré syndrome with reference to cranial neuropathy and its prognostic implication. J Neurosci Rural Pract 2014;5 Suppl 1:S43-7.
4Mazen M, Dimachkie, Barohn RJ. Guillain–Barre syndrome and varients. In: Mazen M, Dimachkie, Barohn RJ, Evans RW, editors. Neurologic Clinics-Peripheral Neuropathies. Vol. 31. Reed Elsevier India Private Limited; 2013. p. 491-510.