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Neurology (Expert Forum)
Re: Knee Pain from Guillain-Barre?
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Re: Knee Pain from Guillain-Barre?
by CCF MD mdf, Jan 01, 1995 12:00AM
Posted By CCF MD mdf on July 08, 1998 at 10:22:36:
In Reply to: Knee Pain from Guillain-Barre? posted by Tina on June 04, 1998 at 09:21:41:
My son, whom is now 11 yrs old, had Guillain-Barre when he was 18 mths old brought on by a severe case of mono. He was affected from waist down and his left arm only. (no upper paralysis) To this day, ALWAYS preceeding an illness, viral or bacterial, he complains of knee pain for approx. 1 week. (sorry-his only discription is tanks playing army in his knee). His pediatrician has sent him for numerous testing, RA, Lupas, etc... all of which show nothing. The last bout was last month. Knee hurt-pain awakening him also at night-then strep throat and pink eye. The pain goes away, except for excessive activities, (he plays baseball), not to return till the next illness. It took 1 1/2 years for the reflexes to come back, is it possible the sheath never healed correctly? Or maybe a lifelong lingering side effect? I have searched all the Guillian sites, and have come across nothing like this. His pediatrician is also at a loss, and asked me to forward any info you may be able to offer. Thank-you for your help.
Tina
=
Sorry about taking so long to respond. It appears that our pediatric neurologists have not been available on the forum in the past month, so I'll take a crack at it.
Residual effects from GBS are known, particularly weakness which represents an incomplete recovery. As you have probably learned by now, GBS is not always the same thing. That is, there are demyelinating forms, axonal forms, primarily motor forms, mixed motor-sensory forms, etc. I suspect that your son had some sensory involvement (very common in GBS), and this is a residual effect.
I would supppose that some residual damage to the sensory nerve(s) to the knee, or perhaps the appropriate lumbar nerve root (L3 or L4) renders it susceptible to symptoms in the face of another illness (particularly one that triggers an immune response). What you report is not common, but one can imagine a physiological basis for it.
It sounds like the knee pain is specific to para-infectious states, and is always self-limiting. That suggests that it won't be necessarily harmful. If this changes in any way (new trigger, lasts too long, distribution or quality of pain changes), I would have that looked into. Things may change during puberty, and that may not necessarily be threatening, but you will want to stay on top of it.
Fascinating. I wish I could give you a better answer. I hope this helps anyway. CCF MD mdf.
In Reply to: Knee Pain from Guillain-Barre? posted by Tina on June 04, 1998 at 09:21:41:
My son, whom is now 11 yrs old, had Guillain-Barre when he was 18 mths old brought on by a severe case of mono. He was affected from waist down and his left arm only. (no upper paralysis) To this day, ALWAYS preceeding an illness, viral or bacterial, he complains of knee pain for approx. 1 week. (sorry-his only discription is tanks playing army in his knee). His pediatrician has sent him for numerous testing, RA, Lupas, etc... all of which show nothing. The last bout was last month. Knee hurt-pain awakening him also at night-then strep throat and pink eye. The pain goes away, except for excessive activities, (he plays baseball), not to return till the next illness. It took 1 1/2 years for the reflexes to come back, is it possible the sheath never healed correctly? Or maybe a lifelong lingering side effect? I have searched all the Guillian sites, and have come across nothing like this. His pediatrician is also at a loss, and asked me to forward any info you may be able to offer. Thank-you for your help.
Tina
=
Sorry about taking so long to respond. It appears that our pediatric neurologists have not been available on the forum in the past month, so I'll take a crack at it.
Residual effects from GBS are known, particularly weakness which represents an incomplete recovery. As you have probably learned by now, GBS is not always the same thing. That is, there are demyelinating forms, axonal forms, primarily motor forms, mixed motor-sensory forms, etc. I suspect that your son had some sensory involvement (very common in GBS), and this is a residual effect.
I would supppose that some residual damage to the sensory nerve(s) to the knee, or perhaps the appropriate lumbar nerve root (L3 or L4) renders it susceptible to symptoms in the face of another illness (particularly one that triggers an immune response). What you report is not common, but one can imagine a physiological basis for it.
It sounds like the knee pain is specific to para-infectious states, and is always self-limiting. That suggests that it won't be necessarily harmful. If this changes in any way (new trigger, lasts too long, distribution or quality of pain changes), I would have that looked into. Things may change during puberty, and that may not necessarily be threatening, but you will want to stay on top of it.
Fascinating. I wish I could give you a better answer. I hope this helps anyway. CCF MD mdf.
