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Case report on atypical Guillain Barre Syndrome with bulbar dysfunction and descending paralysis


Biruk Hailu
Besufikad Worku
Ayalew Zewudie
Hana Ketema

Abstract

Guillain-Barrie syndrome (GBS) is a common cause of acute flaccid, usually ascending paralysis, characterized by symmetrical weakness of the limbs and hyporeflexia or areflexia, which reaches maximum severity within 4 weeks. The motor and sensory axons of the peripheral and autonomic nervous systems may be locally or regionally involved in the atypical presentation group of Guillain-Barré syndrome. We describe the case of a male patient, age 17, who came to our ED with symptoms of bulbar dysfunction and descending arreflexic quadriparesis. A nerve conduction test confirmed the diagnosis of atypical GBS. He was treated in the emergency room with mechanical ventilation support for respiratory failure and airway protection and other fundamental supportive care like analgesia and sedation. He was then admitted to the intensive care unit (ICU) and treated for complications, such as autonomic dysfunction and ventilator-associated pneumonia that arose during his stay at the emergency room. After a three-month stay in the ICU, he was transferred to the medical ward, where he was discharged walking with support and able to feed himself with no swallowing difficulty with instructions on how to comply with ongoing medical management of his dysautonomia and follow-up. 


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eISSN: 2958-9584