When Guillain-Barre syndrome took a wrong path
DOI:
https://doi.org/10.18203/2349-3291.ijcp20230093Keywords:
Pharyngeal cervical brachial variant, Axonal neuropathy, Symmetric descending paralysisAbstract
The pharyngeal cervical brachial (PCB) variant of Guillain-Barre-syndrome (GBS) is defined by rapidly progressive oropharyngeal and cervicobrachial weakness associated with areflexia in upper limbs. On nerve conduction study PCB represents a localized subtype of GBS characterized by axonal rather than demyelinating neuropathy. PCB is often misdiagnosed as brainstem stroke, myasthenia gravis or botulism. Herein we describe a case of symmetric descending type of acute flaccid paralysis with predominant upper limb involvement and also lower limb involvement diagnosed as a PCB- GBS overlap mainly based on nerve conduction study.
References
Sedaghat Z, Karimi N. Guillian barre syndrome associated with COVID 19 infection a case report. J Clin Neurosci. 2020;76:233-5.
Khalifa M, Zakaria F, Ragab Y, Saad A, Bamaga A, Emad Y, Rasker JJ. Guillain barre syndrome associated with severe acute respiratory syndrome coronavirus 2 detection and coronavirus disease 2019 in a child. J Pediatric infect Dis Soc. 2020;9:510-3.
Ropper AH. Further regional variants of acute immune polyneuropathy: bifacial weakness or sixth nerve paresis with paresthesia, lumbar polyradiculopathy, and ataxia with pharyngeal –cervical-brachial weakness. Arch Neurol. 1994;51:671-5.
Sathya GR, Krishnamurthy N, Veliath S. F wave index a diagnostic tool for peripheral neuropathy. Indian J Med Res. 2017;145:353-7.
Koga M, Yuki N, Ariga T, Morimatsu M Hirata K. Is IgG anti GT1a antibody associated with pharyngeal cervical brachial weakness or oropharyngeal palsy in Guillian-Barre syndrome? J Neuroimmunol. 1998;1:74-9.
Wakerly BR, Yukin N. pharyngeal cervical brachial variant of GBS. J Neurol Neurosug Psychiatr. 2014;85:339-44.
Nagashima T, Koga M, Odaka M, Hirata K. continuous sprctrum of pharyngeal cervical brachial variant of Guillian -Barre syndrome. Arch Neurol. 2007;64:1519-23.
Brohi H, Mustaqeem M, Khan S. Pharyngeal cervical variant of Guillian-Barre Syndrome. Pak J Neurological Sci. 2017;12(4):9.
Ravi RP, Sant KY, Shreebodh K, Yadav K. Pharyngeal-cervical-Brachial variant of Guillain-Barre syndrome in children. Cureus 2020;12(2);e6983.
