**4. Discussion**

The recurrence of GBS in pediatrics is rare, as well as the presentation of two clinical variants, which presented different clinical course and remission, despite receiving adequate treatment with intravenous immunoglobulin at a dose of 1 grkg. As previously mentioned, during the 1st episode with acute inflammatory demyelinating variant GBS, the patient presented remission of clinical symptoms without respiratory compromise. But this is not the same way in the 2nd episode of GBS, acute axonal motor variant, where it progresses with acute, torpid neurological evolution, with respiratory and bulbar involvement, meriting phase III ventilation and tracheostomy programming as a protective measure of airway and deficit motor in all 4 extremities for 5 weeks with gradual improvement. Upon discharge, the patient with great limitation to daily activities, staged according to the Hughes Scale in grade IV, found herself confined to bed and requiring the use of a wheelchair to perform daily activities, due to the involvement and motor involvement in the extremities lower, continuing with neurological rehabilitation to delimit the severity of the sequelae.

At present, it is rare to find a case of RGBS, this case being one of the few presentations with an axonal phenotype in a child.

Therefore, it is important for clinicians to recognize the various features of RBGS in recurrence [28].

Remembering that patients may present similar symptoms, but have different findings in the examination, clinical course and electrodiagnostic studies [28, 29].

RGBS may be an underdiagnosed and underrecognized entity in pediatric patients that deserves further study with regard to epidemiology and pathophysiology.
