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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="research-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Journal of Clinical Practice</journal-id><journal-title-group><journal-title xml:lang="en">Journal of Clinical Practice</journal-title><trans-title-group xml:lang="ru"><trans-title>Клиническая практика</trans-title></trans-title-group></journal-title-group><issn publication-format="print">2220-3095</issn><issn publication-format="electronic">2618-8627</issn><publisher><publisher-name xml:lang="en">Eco-Vector</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">628751</article-id><article-id pub-id-type="doi">10.17816/clinpract628751</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Case reports</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Клинические случаи</subject></subj-group><subj-group subj-group-type="article-type"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">A clinical case of acute polyneuropathy, with the onset of bilateral facial nerve palsy in an early childhood</article-title><trans-title-group xml:lang="ru"><trans-title>Клинический случай острой полиневропатии с дебютом двусторонней невропатии лицевого нерва у ребёнка раннего возраста</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8789-4750</contrib-id><contrib-id contrib-id-type="spin">9405-2930</contrib-id><name-alternatives><name xml:lang="en"><surname>Skripchenko</surname><given-names>Elena Yu.</given-names></name><name xml:lang="ru"><surname>Скрипченко</surname><given-names>Елена Юрьевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, PhD, Associate Professor</p></bio><bio xml:lang="ru"><p>д-р мед. наук, доцент</p></bio><email>wwave@yandex.ru</email><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8924-5300</contrib-id><contrib-id contrib-id-type="spin">9667-3210</contrib-id><name-alternatives><name xml:lang="en"><surname>Irikova</surname><given-names>Maria A.</given-names></name><name xml:lang="ru"><surname>Ирикова</surname><given-names>Мария Алексеевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, PhD</p></bio><bio xml:lang="ru"><p>канд. мед. наук</p></bio><email>dr.bedova@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0448-7402</contrib-id><contrib-id contrib-id-type="spin">6190-6930</contrib-id><name-alternatives><name xml:lang="en"><surname>Voitenkov</surname><given-names>Vladislav B.</given-names></name><name xml:lang="ru"><surname>Войтенков</surname><given-names>Владислав Борисович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, PhD</p></bio><bio xml:lang="ru"><p>канд. мед. наук</p></bio><email>vlad203@inbox.ru</email><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff3"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8927-3176</contrib-id><contrib-id contrib-id-type="spin">7980-4060</contrib-id><name-alternatives><name xml:lang="en"><surname>Skripchenko</surname><given-names>Natalia V.</given-names></name><name xml:lang="ru"><surname>Скрипченко</surname><given-names>Наталья Викторовна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, PhD, Professor</p></bio><bio xml:lang="ru"><p>д-р мед. наук, профессор</p></bio><email>snv@niidi.ru</email><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8228-518X</contrib-id><contrib-id contrib-id-type="spin">6716-4945</contrib-id><name-alternatives><name xml:lang="en"><surname>Novokshonov</surname><given-names>Dmitry Yu.</given-names></name><name xml:lang="ru"><surname>Новокшонов</surname><given-names>Дмитрий Юрьевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>dunov7@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2684-9980</contrib-id><contrib-id contrib-id-type="spin">9813-1529</contrib-id><name-alternatives><name xml:lang="en"><surname>Marchenko</surname><given-names>Natalia V.</given-names></name><name xml:lang="ru"><surname>Марченко</surname><given-names>Наталья Викторовна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, PhD</p></bio><bio xml:lang="ru"><p>д-р мед. наук</p></bio><email>gmv2006@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1432-2452</contrib-id><contrib-id contrib-id-type="spin">5748-6114</contrib-id><name-alternatives><name xml:lang="en"><surname>Vishnevetskaya</surname><given-names>Ekaterina M.</given-names></name><name xml:lang="ru"><surname>Вишневецкая</surname><given-names>Екатерина Михайловна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, PhD</p></bio><bio xml:lang="ru"><p>канд. мед. наук</p></bio><email>yekat.mazaeva@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1496-8576</contrib-id><contrib-id contrib-id-type="spin">5096-6322</contrib-id><name-alternatives><name xml:lang="en"><surname>Ivanova</surname><given-names>Galina P.</given-names></name><name xml:lang="ru"><surname>Иванова</surname><given-names>Галина Петровна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, PhD</p></bio><bio xml:lang="ru"><p>д-р мед. наук</p></bio><email>ivanovagp@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8652-8997</contrib-id><contrib-id contrib-id-type="spin">1743-6881</contrib-id><name-alternatives><name xml:lang="en"><surname>Markova</surname><given-names>Ksenia V.</given-names></name><name xml:lang="ru"><surname>Маркова</surname><given-names>Ксения Витальевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, PhD</p></bio><bio xml:lang="ru"><p>канд. мед. наук</p></bio><email>ksenija-sidorova@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4153-4319</contrib-id><contrib-id contrib-id-type="spin">9766-2343</contrib-id><name-alternatives><name xml:lang="en"><surname>Astapova</surname><given-names>Anna V.</given-names></name><name xml:lang="ru"><surname>Астапова</surname><given-names>Анна Владимировна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, PhD</p></bio><bio xml:lang="ru"><p>канд. мед. наук</p></bio><email>anna-syrovcev@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6180-4403</contrib-id><contrib-id contrib-id-type="spin">6309-3260</contrib-id><name-alternatives><name xml:lang="en"><surname>Klimkin</surname><given-names>Andrey V.</given-names></name><name xml:lang="ru"><surname>Климкин</surname><given-names>Андрей Васильевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, PhD</p></bio><bio xml:lang="ru"><p>канд. мед. наук</p></bio><email>klinkinpark@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0001-3449-3080</contrib-id><contrib-id contrib-id-type="spin">5579-8344</contrib-id><name-alternatives><name xml:lang="en"><surname>Golubeva</surname><given-names>Alina V.</given-names></name><name xml:lang="ru"><surname>Голубева</surname><given-names>Алина Владимировна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>golubeva-alinka@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2128-0737</contrib-id><contrib-id contrib-id-type="spin">3792-2450</contrib-id><name-alternatives><name xml:lang="en"><surname>Verbenko</surname><given-names>Polina S.</given-names></name><name xml:lang="ru"><surname>Вербенко</surname><given-names>Полина Сергеевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>lotospoliv@mail.ru</email><xref ref-type="aff" rid="aff2"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Pediatric Research and Clinical Center for Infectious Diseases</institution></aff><aff><institution xml:lang="ru">Детский научно-клинический центр инфекционных болезней</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Saint Petersburg State Pediatric Medical University</institution></aff><aff><institution xml:lang="ru">Санкт-Петербургский государственный педиатрический медицинский университет</institution></aff></aff-alternatives><aff-alternatives id="aff3"><aff><institution xml:lang="en">Academy of Postgraduate Education — Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies</institution></aff><aff><institution xml:lang="ru">Академия постдипломного образования ФГБУ «Федеральный научно-клинический центр специализированных видов медицинской помощи и медицинских технологий»</institution></aff></aff-alternatives><pub-date date-type="preprint" iso-8601-date="2024-06-24" publication-format="electronic"><day>24</day><month>06</month><year>2024</year></pub-date><pub-date date-type="pub" iso-8601-date="2024-07-15" publication-format="electronic"><day>15</day><month>07</month><year>2024</year></pub-date><volume>15</volume><issue>2</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>106</fpage><lpage>115</lpage><history><date date-type="received" iso-8601-date="2024-03-05"><day>05</day><month>03</month><year>2024</year></date><date date-type="accepted" iso-8601-date="2024-05-12"><day>12</day><month>05</month><year>2024</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2024, Eco-Vector</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2024, Эко-Вектор</copyright-statement><copyright-year>2024</copyright-year><copyright-holder xml:lang="en">Eco-Vector</copyright-holder><copyright-holder xml:lang="ru">Эко-Вектор</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by-nc-nd/4.0</ali:license_ref></license></permissions><self-uri xlink:href="https://clinpractice.ru/clinpractice/article/view/628751">https://clinpractice.ru/clinpractice/article/view/628751</self-uri><abstract xml:lang="en"><p><bold>BACKGROUND:</bold> The differential diagnosis of peripheral nervous system damage depends on a thorough collection of history, comprehensive assessment of clinical manifestations, and dynamic examination of the patient. This article describes a clinical case of acute polyneuropathy in a young child, which began with gastrointestinal symptoms and bilateral facial neuropathy.</p> <p><bold>CLINICAL CASE DESCRIPTION:</bold> The article presents a case of a child with an atypical course of acute polyneuropathy, which began with bilateral facial neuropathy combined with gastrointestinal complaints and pain syndrome. Features of the clinical presentation of the disease required extended laboratory and instrumental testing. Protocols for instrumental verification of diagnosis included nerve conduction studies examining neural conduction and axonal excitability of the affected facial nerve and the healthy side. Additionally, the functional status of the peripheral nerves in the upper and lower limbs was assessed. Polyneuropathic alterations revealed through nerve conduction studies confirmed diagnostic lumbar puncture to determine the presence of neuroinfectious processes. Magnetic resonance imaging of the brain, brachial, and lumbosacral plexuses using intravenous contrast showed the nature and prevalence of a lesion. Based on the overall clinical, laboratory, and instrumental examination data of the patient, “acute inflammatory demyelinating polyneuropathy” was diagnosed; timely etiopathogenetic treatment was initiated.</p> <p><bold>CONCLUSION:</bold> In children, the course of a neuroinfection may be atypical. Sometimes, when dissociating the clinical manifestations of the disease from the results of a standard laboratory and instrumental test, expert diagnostic techniques should be used for differential diagnosis purposes.</p></abstract><trans-abstract xml:lang="ru"><p><bold>Обоснование.</bold> Успех дифференциальной диагностики поражения периферической нервной системы зависит от тщательного сбора анамнеза, комплексного анализа клинических проявлений и динамического осмотра пациента. Представляем описание клинического случая острой полиневропатии у ребёнка раннего возраста, которая дебютировала с невропатии лицевого нерва.</p> <p><bold>Описание клинического случая.</bold> Наличие у ребёнка 2,5 лет периферического одностороннего прозопареза в сочетании с гастроинтестинальными жалобами и болевым синдромом привело к расширению протокола дообследования, включающего электронейромиографию с исследованием невральной проводимости и аксональной возбудимости лицевого нерва поражённой и здоровой стороны. Дополнительно исследовали функциональное состояние периферических нервов верхних и нижних конечностей. Выявленные по данным электронейромиографии полиневропатические изменения явились обоснованием к проведению диагностической люмбальной пункции с целью уточнения наличия нейроинфекционного процесса. Результаты магнитно-резонансной томографии головного мозга, плечевых и пояснично-крестцовых сплетений с внутривенным контрастированием позволили уточнить характер и распространённость поражения. По совокупности результатов клинико-лабораторного и инструментального обследования пациента был установлен окончательный диагноз острой воспалительной демиелинизирующей полиневропатии, что позволило в короткие сроки провести коррекцию этиопатогенетической терапии.</p> <p><bold>Заключение.</bold> У детей течение нейроинфекционного процесса может быть атипичным. В ряде случаев при диссоциации клинических проявлений заболевания и результатов стандартного лабораторного и инструментального обследования необходимо с дифференциально-диагностической целью использовать экспертные методы диагностики.</p></trans-abstract><kwd-group xml:lang="en"><kwd>facial palsy</kwd><kwd>children</kwd><kwd>young age</kwd><kwd>polyneuropathy</kwd><kwd>nerve conduction studies</kwd><kwd>magnetic resonance imaging</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>невропатия лицевого нерва</kwd><kwd>дети</kwd><kwd>ранний возраст</kwd><kwd>полиневропатия</kwd><kwd>электронейромиография</kwd><kwd>магнитно-резонансная томография</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Скрипченко Н.В., Команцев В.Н. Инфекционные заболевания периферической нервной системы у детей: руководство для врачей. Москва: Медицина, 2006. 560 с. [Skripchenko NV, Komancev VN. 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