Abstract
Guillain-Barré syndrome (GBS) is generally considered to be monophasic, but recurrences do occur in some patients. We report a case of a 57-year-old male, hypertensive, euglycaemic with prior history of GBS 7 years ago, presented with ascending paraesthesia of all four limbs without prior antecedent infection, followed by subsequent quadriparesis, facial paresis, areflexia with reduced single breath count. Nerve conduction study showed sensory motor demyelinating polyradiculoneuropathy with evidence of conduction block.
Cerebrospinal fluid analysis showed lymphocyte pleocytosis. Magnetic resonance imaging of spine with contrast showed spinal nerves, lumbar plexus roots and cauda equina root enhancement. He recovered from Hughes’s grade 4 to Hughes’s grade 2 following 5 days of intravenous immunoglobin treatment. Our case represents a recurrence of GBS of AIDP variant with lymphocyte predominant CSF pleocytosis, lumbar and cauda equina root enhancement and response to intravenous immunoglobin in a middle-aged male.
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References
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