An unusual presentation of Guillain-Barré syndrome in a young man with bilateral upper extremity weakness.

Autor(es): McNicholas N,O'Dowd S,McNamara B,O'Toole O

Resumo: A 30-year-old man attended the emergency department with a 4-day history of progressive, bilateral upper limb weakness. He had mild shortness of breath and occasional swallowing difficulties. One month prior to presentation, he had flu-like symptoms and diarrhoea. Examination revealed upper limb hypotonia, symmetrical distal arm weakness and hyporeflexia. Power and reflexes in the lower limbs were normal. Nerve conduction studies and lumbar puncture demonstrated features consistent with Guillain-Barré syndrome (GBS). The patient was treated with a 5-day course of intravenous immunoglobulins. He improved significantly over the next 2 weeks. Breathing and swallow function did not deteriorate and required no further intervention. He had a sustained improvement, and remained at baseline 1 year later. Work-up for underlying structural, infectious, inflammatory and paraneoplastic aetiologies were negative. Serum antiganglioside antibodies were positive for the anti-GT1a IgG isotype supporting the clinical diagnosis of the pharyngeal-cervical-brachial variant of GBS.

Imprenta: BMJ Case Reports, v. 2015, 2015

Identificador do objeto digital: 10.1136/bcr-2015-210375

Descritores: Guillain-Barre Syndrome - Antibodies ; Guillain-Barre Syndrome - Clinical examination

Data de publicação: 2015