J Korean Neurol Assoc.  1994 Mar;12(1):164-169.

Pharyngeal-Cervical-Brachial Variants of Guillain-Barre Syndrome

• Kim SY
• Kim SM
• Yu KH
• Kwon KH
• Lee BC

Abstract

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.

MeSH Terms

Arm
Botulism
Diagnosis
Diphtheria
Guillain-Barre Syndrome*
Humans
Leg
Neck
Paresthesia
Reflex
Respiratory Insufficiency
Sensation
Shoulder