Brief Answer:
Consult your pediatrician immediately

Detailed Answer:
Hello

I can understand your concern.Although I have not clinically examined your child;after going through the detail to me it appears to be a case of Acute motor axonal neuropathy(LGBS).This needs urgent medical attention as the progression of weakness may be very rapid and can involve respiratory muscles leading to respiratory failure.
Clinical examination is sufficient to make the diagnosis but an electromyography may be needed.Treatment is intravenous immunoglobulin which is costly medicine(about 30 gm will be needed costing about 60000 Rs.).
The weakness can be due to other causes but it needs to be evaluated urgently.
Don't wait and rush to the hospital immediately.

Please let me know about the further proceedings.
Wish your baby good health.
Regards

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Brief Answer:
Weakness can also be due to electrolyte disbalance

Detailed Answer:
Thanks for writing back.
There can be several causes of weakness.But you specially mentioned that the weakness is more in lower limb which gradually increased and now involved upper limb also.
This ascending type of weakness is characteristic of acute axonal polyneuropathy(LGBS) and it is preceeded by features of viral infection like loose motion and cough/cold.
I am sure that your pediatrician has done all the neurological clinical test to rule out LGBS.
I have seen many cases getting missed initially and eventually landing up in a serious condition.
As said by your doctor weakness can be due to electrolyte disbalance also.But here weakness is usually not localised to legs only.
If she has been cleared by clinical assessment by your doctor I don't think electromyography is needed.Give her ORS to combat electrolyte imbalance.
Assess for the progression of weakness and if it is increasing in severity consult your pediatrician as this may be a missed case of LGBS.

Please let me know if you have any more query.
Wishing for your child's speedy recovery.
Regards

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Brief Answer:
The benefit overweighs the side effect

Detailed Answer:
IVIG administration prevents further progression of weakness in 80% cases.Still there are chances that weakness may progress in 20%.
There are side effects of IVIG like hypersensitivity reaction,headache,fever,nausea,vomiting,flushing etc(usually mild.serious side effect is very less common) etc but it's benefit outweighs the side effect.
So I won't get overly worried for side effect and will pray that weakness does not progress much.

Wishing for your child's speedy recovery
Regards

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Brief Answer:
It may take 2-3 months for complete recovery

Detailed Answer:
I have gone through the NCV report.I am sorry as in hurry earlier I have written electromyography which should be nerve conduction velocity instead.
The report says it is acute motor axonal polyneuropathy as I was suspecting.
The total dose of IVIG is 2gm/kg(400 mg/kg/day for 5 days).
This IVIG helps in preventing further progression of weakness in 80% of cases.
But it may take 2-3 months for regeneration of new nerves and thus complete recovery may take 2-3 months or even more.
Once acute stage subsides physiotherapy shall be needed.
I would like to know the extent of weakness.;whether she able to lift her shoulder above head?
Is there any respiratory difficulty?
What your doctor are saying?
One thing I want to mention that she has received treatment at right time and I hope the weakness will not progress further.
Wishing for her speedy recovery.
Regards

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Brief Answer:
This pain is nerve related pain(neuralgia)

Detailed Answer:
Pain is very common in GBS and this pain is nerve related(neuralgia).This is the reason common analgesics don't help much. Medicine like Gabapentin/amitryptiline helps in this kind of pain.
Vomiting,pain in back of neck are mild side effects of IVIG.You have mentioned that pain in leg increases while receiving IVIG. This may be just a coincidental finding as pain in leg is neuralgia and not due to IVIG.
I wont get overly worried if she is able to lift her arm.This indicates that respiratory muscles are not involved and here the outcome is good.
If there is no difficulty in swallowing and her voice is not affected;you can give semisolid home foods. No specific diet is needed.
Discuss with your physician for gabapentin/amitryptiline for pain relief.

Please do ask if you have any doubt regarding the illness in future and I shall be glad to help you out.To be in follow up you can also ask me direct query in future.
Regards

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Brief Answer:
Seen the image

Detailed Answer:
Thanks for writing back

I have seen the image.I think you have tried to attach a video clip(as mentioned),but here there is a still image.
Through this image I have been able to conclude that your daughter is able to lift her left arm above head(I hope the power in both the upper limb are same).
I wont get overly worried if power in upper limb is good,her voice and swallowing has not affected.
Give her all the healthy and nutritious diet what she wants.
Keep patience.Let your doctor complete total dosage of IVIG.
Continue giving analgesic for leg pain.Ask for the need for gabapentin/amitryptilin.
Follow the advice of physiotherapy.
She will improve gradually.

I will pray for her speedy recovery.
I shall be glad to help you out in future,if you need any.
Wish you all the best.
Regards
http://doctor.healthcaremagic.com/doctors/dr-pradeep-kumar/64036

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