A Rare Pediatric Case of COVID-19-Associated Guillain-Barré Syndrome With Multiple Cranial Neuropathies and Without Pulmonary Symptoms

Coronavirus disease (COVID-19) is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that primarily affects the respiratory system but can also lead to neurological complications such as Guillain-Barré syndrome (GBS). This case report describes an eight-year-old boy with COVID-19-associated GBS involving multiple cranial nerves (third, seventh, and ninth) without pulmonary symptoms. The patient initially presented with flu-like symptoms along with right facial paralysis, which progressed to bilateral facial paralysis, limb weakness, and sensory loss. Neurologic examination revealed a loss of deep tendon reflexes, while cerebrospinal fluid analysis showed albuminocytologic dissociation. The SARS-CoV-2 polymerase chain reaction (PCR) test was positive in the nasopharyngeal swab but negative in the cerebrospinal fluid. The patient was treated with intravenous immunoglobulin (IVIG) and showed marked improvement, regaining the ability to walk unassisted within a week. This case highlights the neuroinvasive potential of SARS-CoV-2 and demonstrates that COVID-19 in pediatric patients can be associated with neurological complications such as GBS, even without respiratory symptoms.