Abstract
Gullian–Barré syndrome (GBS) is an acute autoimmune polyradiculoneuropathy with many variants and distinct presentations. Although cranial neuropathy is a common feature in GBS, third nerve palsy is a rare presentation. Herein, we describe a case of GBS patient who has presented by acute flaccid quadriparesis coexisting bilateral third nerve palsy. We tried to highlight the importance of other cranial nerve involvement in the natural history of GBS.
Highlights
Gullian–Barré syndrome (GBS) is an acute immunemediated polyradiculoneuropathy which often occurs a few days to weeks after an antecedent infection, trauma, surgery or vaccination
Ophtalmoparesis as sixth nerve palsy is mostly seen in Miller-Fisher variant, there are very few instances in the literature where bilateral third nerve palsy in GBS has been reported
St Louis and Jacobson reported a 77 years old man who had been diagnosed with GBS that developed unilateral third nerve palsy, facial and bulbar paralysis over hospitalization.[7]
Summary
Gullian–Barré syndrome (GBS) is an acute immunemediated polyradiculoneuropathy which often occurs a few days to weeks after an antecedent infection, trauma, surgery or vaccination. We describe a case of GBS patient who has presented by acute flaccid quadriparesis coexisting bilateral third nerve palsy. Cranial nerve examination revealed mild bilateral peripheral facial palsy, lack of upward movement of both eyelids. In a passive eyelid opening, the eyes were diverted both outwards and downwards with restricted ocular movements except in lateral eye movement (Figure 1). The pupils were both mydriatic and non-reactive to light (complete bilateral third nerve palsy). The patient had been under lumbar puncture which showed opening cerebrospinal fluid (CSF) pressure 9 CmH2o and normal glucose cell with a protein 304. In addition the patient was able to open his eyes mildly
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
