Background : Progressive  weakness remains the  most important symptomatology for diagnosis of Guillain Barre syndrome (GBS) . However , the perception of weakness is at times overshadowed by other symptoms as perceived by parents and health care workers, especially in the early stages in children. This was a retrospective analysis of factors prompting consideration of alternative diagnosis in children with GBS at a tertiary teaching hospital .

Methods : All children with  GBS admitted  from  May 2013 to May 2018  were analysed. Factors prompting  consideration of alternative diagnosis ( both pre and post hospitalization )  were noted.

Results : Of the forty children analysed, factors found were  trivial fall in 3 children,  weakness being attributed to preceding illness in 2 , severe pain in 2 , meningismus in three  and presence of deep tendon reflexes in two children.  One child with history of trivial fall  presented to the orthopedic department . The other two had a lag period of 2 and 3 days before presenting to the hospital. Of the two children with immediate preceding illness one had a wheeze requiring nebulizations and worsening respiratory parameters were attributed to the respiratory cause. In one child , the presenting symptom was pain, weakness was found on examination.

Conclusion  : Increasing awareness of these  factors helps in preventing diagnostic confusions in children with GBS.