Abstract
The pharyngeal-cervical-brachial variant of Guillain-Barré syndrome is a rare but well documented in the adult population, characterized by rapidly progressive weakness of oropharyngeal and cervicobrachial areas with areflexia in the upper limbs. We describe a 19-year-old young man with predominantly pharyngeal-cervical-brachial weakness and pronounced bulbar symptoms. Atypical Guillain-Barré variants can be challenging in early disease stage and should be considered in the differential diagnosis of a young adult presenting with bulbar palsy.
Highlights
Guillain-Barré syndrome (GBS) is a neurologic disease characterized by ascending paralysis, variable degrees of weakness, sensory abnormalities, and autonomic dysfunction
Almost 50 to 75 percent of the cases are preceded by an infection, whereby Campylobacter jejuni is the most common identified infectious trigger
We present a case of a young man, 19 years old, a soccer player, with asthma, medicated with a rescue inhaler, without other relevant history or family history, was admitted to the Emergency Department due to dysphagia to solids and progressive weakness of the upper limbs with about 24h of evolution
Summary
Guillain-Barré syndrome (GBS) is a neurologic disease characterized by ascending paralysis, variable degrees of weakness, sensory abnormalities, and autonomic dysfunction. We present a case of a young man, 19 years old, a soccer player, with asthma, medicated with a rescue inhaler, without other relevant history or family history, was admitted to the Emergency Department due to dysphagia to solids and progressive weakness of the upper limbs with about 24h of evolution He reported acute gastroenteritis about one week before. On the second day of hospitalization, he was transferred to the Intensive Unit Care because of the rapidly progressive clinical aggravation with development of flaccid tetraparesis with predominance in the upper limbs, dysarthria, severe dysphagia for solids and liquids, and restrictive pulmonary syndrome requiring continuous aspiration of secretions and a nasogastric tube for feeding It was performed a magnetic resonance imaging of the head and spine that had no changes. After one year of follow-up and rehabilitation, the pacient recovered muscle strength of the four limbs and had no speech changes, dysphagia was only completely resolved after 18 months
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