Autoimmune polyendocrinopathy syndrome is a heterogeneous group of rare diseases characterized by autoimmune activity against more than one endocrine organ, although non-endocrine organs can be affected. We present a case of autoimmune polyendocrinopathy syndrome type 2 in a 42-year-old woman with Guillain-Barre syndrome and scleroderma. This combination of syndromes has not been reported and warrants further investigation.
Adult ; Female ; Guillain-Barre Syndrome ; complications ; diagnosis ; Humans ; Polyendocrinopathies, Autoimmune ; diagnosis ; Scleroderma, Diffuse ; complications ; diagnosis

Guillain-Barre Syndrome ; diagnosis ; HIV Infections ; diagnosis ; Humans ; Male ; Middle Aged

Neurologists are occasionally confronted with patients who have unique symptoms of bilateral but regional weaknesses that do not conform to the typical case with Guillain-Barre syndrome (GBS). Acute facial diplegia is a very uncommon neurologic manifestation that can be the presenting symptom in a wide range of diseases. We describe a 32-year-old male patient with acute facial diplegia and distal limb paresthesias without diminished reflexes. His neurophysiologic studies, CSF albuminocytologic dissociation and the clinical course are in keeping with a regional variant of GBS. The absence of hyporeflexia does not necessarily exclude the diagnosis of a GBS variant.
Adult ; Diagnosis ; Extremities ; Guillain-Barre Syndrome* ; Humans ; Male ; Neurologic Manifestations ; Paresthesia ; Reflex ; Reflex, Abnormal

Several clinical variants of Guillain-Barre syndrome(GBS) merit separate description because they simulate other diseases and because they may illuminate the pathophysioloy of the typical illness. Some limited regional forrns of the GBS and unusual focal signs or symptoms that resemble other illnesses are described. A number of patients will have prominent pharyngeal, facial, and neck-flexion weakness at the onset of GBS, which descends to involve the arms, and soon after. The legs. The unusual of distribution of weakness, presenation of leg reflexes, and unusual absence of paresthesias directs diagnostic attention toward myasthenia, botulism, or diphtheria. In a few such patients the illness halts when it has caused severe oropharyngeal. Neck. Shoulder, and proximal arm wealiness. Completely sparing power and reflexes in the legs. We report two cases of unusual clinical variant of GBS, so called pharyngeal-cervical-brachial variants who had bilateral ptosis. Marked oropharyngeal, neck, and shoulder weakness, and with areflexia in the arrns only. And normal sensation. Botulism or diphtheria and, less so, myasthenia, were initially considered diagnoses. The illness progressed to generalized typical GBS with respiratory failure in one patient. In the other patient. The illness halted without affecting power or reflexes in the legs, and electrophysiologic abnormalities were isolated to the face and the arms.
Arm ; Botulism ; Diagnosis ; Diphtheria ; Guillain-Barre Syndrome* ; Humans ; Leg ; Neck ; Paresthesia ; Reflex ; Respiratory Insufficiency ; Sensation ; Shoulder

Guillain-Barre syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy. In typical cases, the first symptoms of GBS are pain, numbness, paresthesia, weakness in the limbs. Autonomic involvement is common and causes urinary retention and ileus. Much of these symptoms overlap with those of lumbar spinal stenosis. Therefore, correct diagnosis of GBS in a patient with symptomatic lumbar spinal stenosis or in a patient with atypical manifestations of GBS can be difficult, especially early in the course of GBS. Here, we report on a case of atypical GBS in a 74-year-old previously healthy patient with lumbar spinal stenosis and discuss the differential diagnosis of the GBS and lumbar spinal stenosis.
Diagnosis, Differential ; Extremities ; Guillain-Barre Syndrome ; Humans ; Hypesthesia ; Ileus ; Paresthesia ; Polyradiculopathy ; Spinal Stenosis ; Urinary Retention

Guillain-Barré syndrome (GBS) is nowadays consider as an umbrella term that has heterogenous presentation depend on their subtypes. GBS is clinical diagnosis and its diagnosis can be supported by laboratory findings from cerebral spinal fluid study, nerve conduction study, anti-ganglioside antibodies, spinal magnetic resonance imaging and nerve ultrasound. Understanding atypical subtypes and GBS mimicking diseases are crucial for correct diagnosis. Both proper medical care for respiratory and autonomic dysfunction and immunotherapy are essential to improve outcome of GBS. Here, we summarized the current concept on diagnosis, immunopathophysiology and treatment of GBS.
Antibodies ; Diagnosis ; Guillain-Barre Syndrome ; Immunotherapy ; Magnetic Resonance Imaging ; Neural Conduction ; Ultrasonography

OBJECTIVE: To study the clinical features of children with Guillain-Barré syndrome (GBS) and the significance of Brighton criteria in childhood GBS. METHODS: A retrospective analysis was performed on the medical data of 72 children with GBS. Brighton criteria were used for the grading of diagnostic certainty (level 1 as the highest level, and level 4 as the lowest level). A Spearman's rank correlation analysis was used to evaluate the correlation of auxiliary examinations with the level of diagnostic certainty of Brighton criteria. RESULTS: A total of 72 children with GBS were enrolled, with a mean age of onset of (98±32) months. All children (100%, 72/72) had weakness of bilateral limbs and disappearance or reduction of tendon reflex, and limb weakness reached the highest level of severity within 4 weeks. Of all the 72 children, 68 (94%) had positive results of neural electrophysiological examination and 51 (71%) had positive results of cerebrospinal fluid (CSF) examination, and the positive rate of neural electrophysiological examination was significantly higher than that of CSF examination ( CONCLUSIONS Most of the children with GBS meet Brighton criteria level 1, and the positive results of CSF examination and neural electrophysiological examination play an important role in improving the level of diagnostic certainty of Brighton criteria. Neural electrophysiological examination has a higher positive rate than CSF examination in the early stage of the disease.
Child ; Child, Preschool ; Extremities ; Guillain-Barre Syndrome/diagnosis* ; Humans ; Muscle Weakness ; Physical Examination ; Retrospective Studies

Miller Fisher syndrome is characterized by acute external ophthalmoplegia, ataxia and areflexia in the abscence of significant motor or sensory deficit in the limbs and usually results in a complete recovery. Most cases have anteceding events like upper respiratory infection or other viral infections. Diagnosis of Miller fisher syndrome can be made with compatible clinical history taking, cardinal symptoms and normal findings of CT or MRI. The prognosis of Miller Fisher syndrome is favorable contrary to other malignant tumors or Guillain-Barre syndrome which sometimes cause a respiratory paralysis. The locations of its anatomic lesion and pathogenesis are nor yet discovered. From 1991 to 1995, we have experienced 11 cases of Miller Fisher syndrome. Thereby we have analyzed anteceding events, cardinal symptoms along with other associated symptoms, electrophysiological studies, cerebrospinal fluid test and its treatment and prognosis. The purpose of this article is that a better understanding of Miller Fisher syndrome can lead us to differenciate with other disorders causing external ophthalmoplegia.
Ataxia ; Cerebrospinal Fluid ; Diagnosis ; Extremities ; Guillain-Barre Syndrome ; Magnetic Resonance Imaging ; Miller Fisher Syndrome* ; Ophthalmoplegia ; Prognosis ; Respiratory Paralysis

Hyponatremia is one of the most common electrolyte disturbances in nephrologic clinical setting. SIADH is one of the causes of hyponatremia and can be accompanied with various conditions such as malignancies, infections and nervous system diseases. Guillain-Barre syndrome is an acute inflammatory polyneuropathy. It is reported that SIADH can be accompanied with Guillain-Barre syndrome although the mechanism is unclear. Symptoms of Guillain- Barre syndrome such as general weakness, decreased consciousness, and seizure are similar to those of hyponatremia. Thus the diagnosis of Guillain-Barre syndrome can be delayed if they coexist. Because Guillain-Barre syndrome leads to severe respiratory failure in its disease course and mechanical ventilatory assistance is mandatory for such cases, early diagnosis and treatment is critical. Korea is still endemic area for tuberculosis and clinicians often experience pulmonary tuberculosis in practice. But pulmonary tuberculosis-associated SIADH and Guillain-Barre syndrome were not reported in Korea. So far, 2 cases of gastrointestinal infection-associated SIADH and Guillain-Barre syndrome were reported. Hence, authors report here the case of SIADH associated Guillain-Barre syndrome associated with pulmonary tuberculosis.
Consciousness ; Early Diagnosis ; Guillain-Barre Syndrome ; Hyponatremia ; Inappropriate ADH Syndrome ; Korea ; Nervous System ; Respiratory Insufficiency ; Seizures ; Tuberculosis ; Tuberculosis, Pulmonary

A 59-year-old man was admitted with numbness, pain, and a tingling sensation in both lower legs. He was initially diagnosed with diabetic peripheral neuropathy based on a symptom questionnaire and a quantitative sensory test. Despite symptomatic treatment of diabetic neuropathy, he complained of worsening sensory symptoms and additional motor weakness in both lower extremities. As the motor weakness of both extremities became more aggravated over time, brain and spine imaging tests and a nerve conduction test were performed. The nerve conduction study revealed motor and sensory axonal neuropathy. In his cerebrospinal analysis, albumino-cytologic dissociation, which is compatible to the Gillian-Barre syndrome, was found. Cerebrospinal fluid analysis showed albumino-cytologic dissociation. He was treated with intravenous immunoglobulin and his neurologic deficits were gradually improved.
Diabetic Neuropathies/*complications/*diagnosis ; Electromyography ; Guillain-Barre Syndrome/*complications/*diagnosis ; Humans ; Male ; Middle Aged ; Neural Conduction ; Neurologic Examination