Asymmetric Lower Extremity Involvement and Facial Palsy: An Atypical Case of Guillain-Barre Syndrome

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2020 Aug 4

PMID 32742878

Citations 1

Authors

Anas Albawaliz

Dina Abdallah

Gurpreet K Seehra

Ahmed Elkafrawy

Ahmad Al-Shyoukh

Affiliations

Soon will be listed here.

Abstract

Guillain-Barre syndrome (GBS) represents the most common cause of acute flaccid paralysis and is characterized by muscle weakness frequently accompanied by respiratory and bulbar paralysis which oftentimes can be life-threatening. Early recognition and intervention are essential to prevent potential complications and help hasten recovery. Herein, we report a case of a middle-aged female who presented with nonspecific gastrointestinal symptoms that were shortly followed by a unique combination of new-onset facial diplegia and asymmetric lower extremity areflexia. Treatment with intravenous immunoglobulins (IVIG) was initiated following a prompt diagnosis of GBS was made. Clinicians should always be vigilant about the possibility of GBS in the appropriate clinical setting and be aware of the essentials of management of this potentially treatable disease.

Citing Articles

An Analysis of Respiratory Muscle Paralysis of Adult Patients in Guillain-Barré Syndrome: A Retrospective Analysis.

Wang A, Wang X, Wang X, Li G, Zhong D Medicina (Kaunas). 2023; 59(7).

PMID: 37512077 PMC: 10384571. DOI: 10.3390/medicina59071267.

References

Logullo F, Manicone M, Di Bella P, Provinciali L . Asymmetric Guillain-Barré syndrome. Neurol Sci. 2006; 27(5):355-9. DOI: 10.1007/s10072-006-0710-z. View

Jacobs B, Rothbarth P, van der Meche F, Herbrink P, Schmitz P, de Klerk M . The spectrum of antecedent infections in Guillain-Barré syndrome: a case-control study. Neurology. 1998; 51(4):1110-5. DOI: 10.1212/wnl.51.4.1110. View

Kiriyama T, Hirano M, Kusunoki S, Morita D, Hirakawa M, Tonomura Y . Asymmetrical weakness associated with central nervous system involvement in a patient with guillain-barrè syndrome. Clin Med Case Rep. 2013; 2:51-4. PMC: 3785336. DOI: 10.4137/ccrep.s3180. View

. Plasmapheresis and acute Guillain-Barré syndrome. The Guillain-Barré syndrome Study Group. Neurology. 1985; 35(8):1096-104. View

Ropper A . The Guillain-Barré syndrome. N Engl J Med. 1992; 326(17):1130-6. DOI: 10.1056/NEJM199204233261706. View

Yosha-Orpaz N, Aharoni S, Rabie M, Nevo Y . Atypical Clinical Presentations of Pediatric Acute Immune-Mediated Polyneuropathy. J Child Neurol. 2019; 34(5):268-276. DOI: 10.1177/0883073818825213. View

Hughes R, Swan A, van Doorn P . Intravenous immunoglobulin for Guillain-Barré syndrome. Cochrane Database Syst Rev. 2014; (9):CD002063. PMC: 6781841. DOI: 10.1002/14651858.CD002063.pub6. View

van der Meche F, van Doorn P, Meulstee J, Jennekens F . Diagnostic and classification criteria for the Guillain-Barré syndrome. Eur Neurol. 2001; 45(3):133-9. DOI: 10.1159/000052111. View

Asbury A, Cornblath D . Assessment of current diagnostic criteria for Guillain-Barré syndrome. Ann Neurol. 1990; 27 Suppl:S21-4. DOI: 10.1002/ana.410270707. View

10.

Yuki N, Kokubun N, Kuwabara S, Sekiguchi Y, Ito M, Odaka M . Guillain-Barré syndrome associated with normal or exaggerated tendon reflexes. J Neurol. 2011; 259(6):1181-90. DOI: 10.1007/s00415-011-6330-4. View

11.

Singhal V, Bhat K . Guillain-Barre syndrome with hyperreflexia: A variant. J Pediatr Neurosci. 2012; 6(2):144-5. PMC: 3296413. DOI: 10.4103/1817-1745.92844. View

12.

Hargis M . Atypical Asymmetric Guillain-Barré Syndrome With Acute Rhabdomyolysis. J Clin Neuromuscul Dis. 2017; 19(2):96. DOI: 10.1097/CND.0000000000000175. View

13.

van den Berg B, Walgaard C, Drenthen J, Fokke C, Jacobs B, van Doorn P . Guillain-Barré syndrome: pathogenesis, diagnosis, treatment and prognosis. Nat Rev Neurol. 2014; 10(8):469-82. DOI: 10.1038/nrneurol.2014.121. View

14.

Willison H, Jacobs B, van Doorn P . Guillain-Barré syndrome. Lancet. 2016; 388(10045):717-27. DOI: 10.1016/S0140-6736(16)00339-1. View