Abstract
Guillain-Barre syndrome (GBS) is an autoimmune disorder manifested as acute, rapidly progressive ascending paralysis with usually bilateral cranial nerve involvement. Facial nerve is most commonly involved usually bilateral but rarely unilateral. Here we are reporting such a rare case of unilateral facial nerve palsy in GBS. The electrophysiological tests including blink study are important in such cases. Our patient had mixed pathological features of demyelinating polyneuropathy in motor nerves of upper / lower limbs and motor axonopathy in both facial nerve (left > right) which is a rare combination seen in GBS patients. This can be a new variant seen in GBS patients which is first of its kind.
Keywords: Guillain-Barre Syndrome, Axonopathy, Demyelinating polyneuropathy, Unilateral Facial Nerve Palsy, Blink Reflexes.
References
1. Hauser SL, Asbury AK. Guillain-Barre syndrome and other immune-mediated neuropathies. harrisons principles of internal medicine. 2005;16(2):2513.
2. Asbury AK, Cornblath DR. Assessment of current diagnostic criteria for Guillain‐Barré syndrome. Annals of neurology. 1990 Jan 1;27(S1).
3. Smith N, Grattan‐Smith P, Andrews PI, Kainer G. Acquired facial palsy with hypertension secondary to Guillain–Barre syndrome. Journal of paediatrics and child health. 2010 Mar 1;46(3):125-7.
4. Ropper AH. The Guillain–Barré syndrome. New England Journal of Medicine. 1992 Apr 23;326(17):1130-6.
5. Winer JB. Guillain–Barré syndrome: Clinical variants and their pathogenesis. Journal of neuroimmunology. 2011 Feb 28;231(1):70-2.
6. Verma R, Chaudhari TS, Giri P. Unilateral facial palsy in Guillain-Barre syndrome (GBS): a rare occurrence. BMJ case reports. 2012 Oct 19;2012:bcr2012007077.
7. Kamihiro N, Higashigawa M, Yamamoto T, Yoshino A, Sakata K, Nashida Y, Maji T, Fujiwara T, Inoue M. Acute motor-sensory axonal Guillain–Barré syndrome with unilateral facial nerve paralysis after rotavirus gastroenteritis in a 2-year-old boy. Journal of Infection and Chemotherapy. 2012 Jan 1;18(1):119-23.
8. Sakakibara Y, Mori M, Kuwabara S, Katayama K, Hattori T, Koga M, Yuki N. Unilateral cranial and phrenic nerve involvement in axonal Guillain–Barré syndrome. Muscle & nerve. 2002 Feb 1;25(2):297-9.
9. Crone C, Krarup C. Diagnosis of acute neuropathies. Journal of neurology. 2007 Sep 1;254(9):1151-69.
10. Kumar P, Charaniya R, Bahl A, Ghosh A, Dixit J. Facial Diplegia with Paresthesia: An Uncommon Variant of Guillain–Barre Syndrome. Journal of clinical and diagnostic research: JCDR. 2016 Jul;10(7):OD01
Corresponding Author
Dr Nutan Kumar.D.M
Junior Resident, Department of Medicine, Kempegowda Institute of Medical Sciences, K.R Road, V.V Puram, Bangalore- 560004, Contact No: +919844596676
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
DOI: https://dx.doi.org/10.18535/jmscr/v5i7.12
