Ann Rehabil Med.  2013 Oct;37(5):740-744. 10.5535/arm.2013.37.5.740.

Multiple Cranial Neuropathies Without Limb Involvements: Guillain-Barre Syndrome Variant?

• Yu JY
• Jung HY
• Kim CH
• Kim HS
• Kim MO

• KMID: 2266596
• DOI: http://doi.org/10.5535/arm.2013.37.5.740

Abstract

Acute multiple cranial neuropathies are considered as variant of Guillain-Barre syndrome, which are immune-mediated diseases triggered by various cases. It is a rare disease which is related to infectious, inflammatory or systemic diseases. According to previous case reports, those affected can exhibit almost bilateral facial nerve palsy, then followed by bulbar dysfunctions (cranial nerves IX and X) accompanied by limb weakness and walking difficulties due to motor and/or sensory dysfunctions. Furthermore, reported cases of the acute multiple cranial neuropathies show electrophysiological abnormalities compatible with the typical Guillain-Barre syndromes (GBS). We recently experienced a patient with a benign infectious disease who subsequently developed symptoms of variant GBS. Here, we describe the case of a 48-year-old male patient who developed multiple symptoms of cranial neuropathy without limb weakness. His laboratory findings showed a positive result for anti-GQ1b IgG antibody. As compared with previously described variants of GBS, the patient exhibited widespread cranial neuropathy, which included neuropathies of cranial nerves III-XII, without limb involvement or ataxia.

Keyword

Guillain-Barre syndrome; Cranial neuropathies; Bulbar palsy

MeSH Terms

Ataxia
Bulbar Palsy, Progressive
Communicable Diseases
Cranial Nerve Diseases*
Cranial Nerves
Extremities*
Facial Nerve
Guillain-Barre Syndrome*
Humans
Immunoglobulin G
Male
Middle Aged
Paralysis
Rare Diseases
Walking
Immunoglobulin G

Figure

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  Fig. 1 He showed bilateral ptosis and internal strabismus.

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  Fig. 2 The videofluoroscopic swallowing study on lateral view showed remnant of material in valleculae space and pyriform sinus.

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