Abstract
Guillain‐Barré syndrome (GBS) is a relatively uncommon post-infectious, immune‐mediated neurologic disorder with an incidence of 0.5-2/100,000. It is usually preceded by an infection that evokes an immune response that cross-reacts with peripheral nerve components via molecular mimicry. The presentation of this disorder has several forms, including acute inflammatory demyelinating polyneuropathy (AIDP), acute motor axonal neuropathy (AMAN), acute motor-sensory axonal neuropathy (AMSAN), and Miller Fisher syndrome (MFS). The case we describe is of a 57-year-old male presenting with sensory features followed by symmetrical ascending paralysis and diagnosed with ASMAN, a recently described subtype of GBS, based on neurological and laboratory findings.
Highlights
Guillain‐Barré Syndrome (GBS) is a relatively uncommon post-infectious, immune‐mediated neurologic disorder with an incidence of 0.5-2/100,000 characterized by the demyelination of spinal nerve roots and peripheral nerves, and presents with a mono-phasic illness with cerebrospinal fluid (CSF) albuminocytological dissociation with partial or complete recovery [1]
GBS is diagnosed on the basis of a clinical evaluation, CSF findings, and the results of nerve conduction studies
All patients initially identified as GBS or related disorders can be subclassified as having classical GBS, classic Miller-Fisher Syndrome (MFS), ASMAN, pharyngeal-cervical-brachial (PCB), paraparetic GBS, bifacial weakness with paresthesia, acute ophthalmoparesis (AO), and overlap syndrome [1]
Summary
Guillain‐Barré Syndrome (GBS) is a relatively uncommon post-infectious, immune‐mediated neurologic disorder with an incidence of 0.5-2/100,000 characterized by the demyelination of spinal nerve roots and peripheral nerves, and presents with a mono-phasic illness with cerebrospinal fluid (CSF) albuminocytological dissociation with partial or complete recovery [1]. Besides the classic presentation of GBS, clinical variants are based on the types of nerve fibers involved, the predominant mode of fiber injury (demyelinating versus axonal), and the presence of an alteration in consciousness [3]. A 57-year-old male, with no significant past medical history, presented to the emergency department with the complaint of bilateral lower extremity numbness and tingling for two days that was gradually progressive and associated with bilateral lower limb weakness for one day. He didn’t report any history of recent gastrointestinal or respiratory tract infections.
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