Bilateral facial nerve enhancement demonstrated by magnetic resonance imaging in Guillain–Barre Syndrome

Abstract

Guillain-Barré syndrome (GBS) is an acute inflammatory demyelinating peripheral nerve disorder. It is known that gadolinium enhancement on magnetic resonance imaging (MRI) reflects alteration of the blood-nerve barrier secondary to inflammation. Enhancement of the cauda equina roots with gadolinium on lumbosacral magnetic resonance imaging have been demonstrated in several reports. Although about 50% of GBS patients clinically exhibit facial nerve involvement, it has never been demonstrated on MRI. We aimed to observe facial nerve involvement in a GBS patient who has prominent facial diplegia. With the guidance of the literature, we predict that MRI in selected GBS patients may be an adjunct tool for the clinician in both diagnosis and monitoring the treatment response.

Redefining the Guillain-Barré Spectrum in Children: Neuroimaging Findings of Cranial Nerve Involvement

“…24 In this study, we did find contrast enhancement of the facial nerves in 1 patient, though 5 patients presented with facial nerve palsy. Furthermore, of the 3 patients who demonstrated involvement of the oculomotor cranial nerve, only 1 had ophthalmoplegia.…”

Magnetic resonance imaging findings in Guillain-Barré syndrome caused by Zika virus infection

“…1c, d) showed enhancement in the medullary cone, in the roots of cauda equina in dorsal, and in ventral nerve roots; T2 images revealed increased signal intensity in the spinal ganglia bilaterally at all levels of the lumbar spine with intense contrast enhancement. These features have been described in prior cases of GBS [5] and attributed to demyelination, ischemia, inflammation, and breakdown of the bloodnerve barrier, as occurs in autoimmune polyneuropathy [4,5]. In conclusion, imaging studies can assist in the differential diagnosis of complications in patients with Zika.…”

Guillain-Barré Syndrome and Related Disorders

“…28.3 ) [ 124,125 ] . Occasionally, the facial nerves may also enhance with gadolinium in GBS patients with facial palsies [ 126 ] .…”