Gullian- Barre Syndrome in Pregnancy – A Case Report and Review of the Literature

Abstract

The immune-mediated Gullian- Barre syndrome (GBS) is an acute demyelinating polyradiculopathy (AIDP) which typically presents as progressive, fairly symmetric muscle weakness accompanied by absent or depressed deep tendon reflexes. It has been linked to various infectious agents, such as Campilobacter jejuni and typically presents 2-4 weeks following a respiratory or gastrointestinal illness. With an estimated incidence in the general population of 0.75-2:100,000, its occurrence in pregnancy does not differ. Diagnostic criteria consist of clinical, laboratory and electrophysiological tests. Treatment of pregnant and non-pregnant patients with GBS usually does not differ and it is mainly composed of supportive care and monitoring of respiratory, cardiac and hemodynamic functions. Disease modifying treatments such as plasmapheresis and intravenous immunoglobulin (IVIG) are relatively safe in pregnancy. Timing and mode of delivery are based on obstetric indications and depend on maternal and fetal status. As such, if a pre-term delivery is indicated a course of antenatal corticosteroids should be considered. Therefore, GBS in pregnancy should be handled by a multidisciplinary team involving neurologists, obstetricians and anesthesiologists. We present a case report of an otherwise healthy woman diagnosed with GBS in pregnancy. Patient presentation, diagnosis, treatment and outcome as well of review of the literature will be discussed.