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Volume 12
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10.3390/children12101379
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Case Report

Pediatric Cardiac Arrest Secondary to Guillain-Barré Syndrome-Induced Dysautonomia

by
Po-Jung Chen
1,
Yi-Ting Cheng
2,
Shao-Hsuan Hsia
3,
Oi-Wa Chan
4,
En-Pei Lee
4,
Kuang-Lin Lin
2,5 and
Jainn-Jim Lin
2,4,5,*,†
1
Department of Pediatric Cardiology, Chang Gung Children’s Hospital and Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan 33342, Taiwan
2
Division of Pediatric Neurology, Chang Gung Children’s Hospital and Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan 33342, Taiwan
3
Department of Physician Assistant, University of Maryland Eastern Shore, Princess Ann, MD 21853, USA
4
Division of Pediatric Critical Care Medicine and Pediatric Neurocritical Care Center, Chang Gung Children’s Hospital and Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan 33342, Taiwan
5
Study Group for Intensive and Integrated Care of Pediatric Central Nervous System (iCNS Group), Chang Gung Children’s Hospital, Taoyuan 33342, Taiwan
*
Author to whom correspondence should be addressed.
†
Current address: Division of Pediatric Critical Care Medicine, Chang Gung Children’s Hospital, 5 Fu-Shin Street, Kwei-Shan, Taoyuan 33342, Taiwan.
Children 2025, 12(10), 1379; https://doi.org/10.3390/children12101379
Submission received: 27 July 2025 / Revised: 29 August 2025 / Accepted: 12 September 2025 / Published: 13 October 2025
(This article belongs to the Section Pediatric Neurology & Neurodevelopmental Disorders)
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Abstract

Background: Guillain-Barré syndrome (GBS) is an acute immune-mediated polyneuropathy often associated with autonomic dysfunction. Although transient cardiovascular instability is common, severe dysautonomia leading to cardiac arrest is rarely documented in children. Methods: We report the case of an 11-year-old previously healthy boy who initially presented with acute ophthalmoplegia and rapidly progressed to quadriplegia and areflexia. He developed fluctuating blood pressure and bradycardia, culminating in cardiac arrest due to asystole at 24 h after admission, requiring 17 min of resuscitation. Results: Electrophysiological studies confirmed a demyelinating polyneuropathy. Although intravenous immunoglobulin (IVIG) was initiated 5 h after admission, clinical improvement was achieved only after subsequent plasmapheresis on day 20, with the recovery of autonomic function by day 35. He was extubated on day 45 and discharged on day 83 with a near-complete recovery after prolonged intensive care and rehabilitation. Conclusion: This case highlights the potential for rapid and life-threatening autonomic instability in pediatric GBS. Unlike typical cases, the patient progressed to cardiac arrest within 24 h despite IVIG, highlighting the need to consider plasmapheresis for non-responders. Continuous hemodynamic monitoring is essential to prevent fatal outcomes, even in patients with initially mild or atypical presentations.
Keywords: Guillain-Barré syndrome; children; dysautonomia; cardiac arrest; polyneuropathy; IVIG; plasmapheresis Guillain-Barré syndrome; children; dysautonomia; cardiac arrest; polyneuropathy; IVIG; plasmapheresis

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MDPI and ACS Style

Chen, P.-J.; Cheng, Y.-T.; Hsia, S.-H.; Chan, O.-W.; Lee, E.-P.; Lin, K.-L.; Lin, J.-J. Pediatric Cardiac Arrest Secondary to Guillain-Barré Syndrome-Induced Dysautonomia. Children 2025, 12, 1379. https://doi.org/10.3390/children12101379

AMA Style

Chen P-J, Cheng Y-T, Hsia S-H, Chan O-W, Lee E-P, Lin K-L, Lin J-J. Pediatric Cardiac Arrest Secondary to Guillain-Barré Syndrome-Induced Dysautonomia. Children. 2025; 12(10):1379. https://doi.org/10.3390/children12101379

Chicago/Turabian Style

Chen, Po-Jung, Yi-Ting Cheng, Shao-Hsuan Hsia, Oi-Wa Chan, En-Pei Lee, Kuang-Lin Lin, and Jainn-Jim Lin. 2025. "Pediatric Cardiac Arrest Secondary to Guillain-Barré Syndrome-Induced Dysautonomia" Children 12, no. 10: 1379. https://doi.org/10.3390/children12101379

APA Style

Chen, P.-J., Cheng, Y.-T., Hsia, S.-H., Chan, O.-W., Lee, E.-P., Lin, K.-L., & Lin, J.-J. (2025). Pediatric Cardiac Arrest Secondary to Guillain-Barré Syndrome-Induced Dysautonomia. Children, 12(10), 1379. https://doi.org/10.3390/children12101379

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