Atypical Guillain-Barré syndrome presenting with fluctuating weakness

Autor: Lauren L. Crowther, Amarjyot K. Randhawa, Robert W. Plambeck
Rok vydání: 2022
Předmět:
Zdroj: Proc (Bayl Univ Med Cent)
ISSN: 1525-3252
0899-8280
DOI: 10.1080/08998280.2022.2126930
Popis: Guillain-Barré Syndrome (GBS) is an immune-mediated polyneuropathy, most often occurring within weeks of an infection. Cases of COVID-19–related GBS have been reported, and the typical presentation is a progressive ascending paralysis. We describe a case of a 40-year-old with recent symptomatic COVID-19 who presented with atypical GBS findings, hand weakness that progressed to tetraplegia within 24 hours. He had hyperreflexia on his initial exam and did not meet diagnostic criteria for GBS. Inconsistent neurological findings with spontaneous improvement of symptoms, unremarkable initial evaluation including lumbar puncture, and anxiety further complicated the diagnosis. On day 6, he was intubated for diaphragmatic paralysis, and repeat lumbar puncture showed albumin-cytologic dissociation. Intravenous immunoglobulin followed by plasmapheresis improved strength and allowed for extubation. This case highlights the difficulty of recognizing heterogenic GBS presentations.
Databáze: OpenAIRE