Paediatric pure motor Guillain–Barré syndrome without antecedent infection: An uncommon clinical scenario

Guillain–Barré syndrome (GBS) is a sudden-onset autoimmune disorder that targets the peripheral nervous system, typically occurring after infections and manifesting as a swiftly advancing, symmetrical muscle weakness. Paediatric GBS is rare and often presents diagnostic challenges, particularly in atypical forms such as pure motor variants without preceding infections. The subject is a 9-year-old male child presenting with rapidly progressive lower limb weakness, absent deep tendon reflexes and impaired ambulation and having no antecedent respiratory or gastrointestinal illness, trauma or fever. Nerve conduction studies indicated both motor axonal and demyelinating features consistent with a motor-predominant clinical subtype of GBS. Therapy with intravenous immunoglobulin (IVIg) was initiated as the primary treatment for 3 days, along with pain management and electrolyte correction as supportive care. Following treatment, the patient demonstrated significant neurological improvement and was discharged with preserved ambulation. Early diagnosis, prompt IVIg therapy and correction of metabolic imbalances contributed to a favourable outcome. Clinicians must remain vigilant for GBS, even when typical antecedent factors are not present.