Pharyngeal-cervical-brachial variant of Guillain-Barre syndrome

Wakerley, Benjamin R; Yuki, Nobuhiro

doi:10.1136/jnnp-2013-305397

Cited by 111 publications

(136 citation statements)

References 34 publications

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“…The incidence of pharyngeal-cervical-brachial variant is also not much common [3]. This variant does not cause generalized limb weakness also it is commonly associated with axonal variety rather than demyelinating polyradiculoneuropathy [7]. Raised CSF proteins and demyelinating features on nerve conduction studies are the other features to support the diagnosis of the case.…”

Section: Postulated Immunopathogenesis Of Guillain Barre Syndrome: [5]mentioning

confidence: 92%

Faecal Incontinence in Gullain-Barre Syndrome with Bulbar Palsy-A Case Report with Review of Literature

Kar¹,

Chowdhury²

2016

J Clin Exp Cardiolog

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Autonomic dysfunction is common in association with Guillain-Barre Syndrome. Cardiovascular involvement is the most common in this context. But isolated faecal incontinence as parasympathetic hyperactivity is the rarest event. In this case report, we documented a case of Guillain-Barre Syndrome with bulbar palsy and diarrhoea for 3 weeks without detectable pathology and not responding to conventional therapies.

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Section: Postulated Immunopathogenesis Of Guillain Barre Syndrome: [5]mentioning

confidence: 92%

Faecal Incontinence in Gullain-Barre Syndrome with Bulbar Palsy-A Case Report with Review of Literature

Kar¹,

Chowdhury²

2016

J Clin Exp Cardiolog

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“…The pharyngeal-cervical-brachial (PCB) variant of GBS is characterized by facial palsy, dysarthria, upper extremity muscle weakness and areflexia in the upper limbs [2]. Nerve conduction studies suggest that the PCB variant displays axonal rather than demyelinating neuropathy [2].…”

Section: Introductionmentioning

confidence: 99%

Pharyngeal-Cervical-Brachial Variant of Guillain-Barre Syndrome

Hall

2014

J Neurol Res

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Guillain-Barre syndrome (GBS) is the most common cause of acute neuromuscular paralysis in the Western world. We describe the only known case presentation of pharyngeal-cervical-brachial variant following a subacute myocardial infarction and Vibrio cholerae vaccination. A 55-year-old Filipino man presented to our emergency department with a one-day history of progressive oropharyngeal and cervicobrachial weakness and areflexia in the upper limbs. His review of systems was unremarkable except for receiving "Dukoral" traveller's diarrhea vaccine 3 weeks prior. His physical exam was compatible with GBS. EMG and nerve conduction studies showed low motor amplitudes, prolonged distal latency and absent F-waves in the arms. Lumbar puncture showed a protein level of 579 mg/L. Nuclear perfusion scan was consistent with a subacute myocardial infarction. He received a 2-day course of intravenous immunoglobulin. He showed significant improvement in his weakness over 3 days. Recent vaccination and myocardial infarction may be important triggers for GBS onset.

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“…PCB/MFS typically is an acute monophasic illness that presents with relatively symmetric oropharyngeal, cervical, and arm weakness in addition to ophthalmoplegia and ataxia. 1 This combination of symptoms can be of variable degree, though typically present. 1 Our patient meets the diagnostic criteria except that he had no evidence of ataxia.…”

Section: Sectionmentioning

confidence: 99%

“…1 This combination of symptoms can be of variable degree, though typically present. 1 Our patient meets the diagnostic criteria except that he had no evidence of ataxia. In this case, however, weakness was severe, which may have obscured ataxia.…”

Section: Sectionmentioning

confidence: 99%

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Clinical Reasoning: Oculobulbar dysfunction

Karwa

Nozaki

2017

Neurology

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A 45-year-old man presented a few days after an upper respiratory tract infection with complaints of diplopia, dizziness, and difficulty walking that progressed within a few hours to complete ophthalmoplegia and facial diplegia. Brain MRI showed nonspecific T2 hyperintensities prior to transfer to our facility. On arrival, he was alert and oriented to person, place, and time. Pupils were dilated nonreactive and corneal reflexes were absent bilaterally. He had complete ophthalmoplegia, facial diplegia, and areflexia. His strength in the extremities per Medical Research Council (MRC) scale on initial presentation was preserved at 5/5. His clinical status declined rapidly, necessitating intubation for respiratory failure. Routine blood laboratory workup for infections, metabolic derangements including vitamin B 1 , and thyroid function tests were within normal limits. On day 1, CSF testing showed mildly elevated protein of 47 mg/dL with a normal cell count. CSF cultures and herpes simplex virus (HSV) testing were negative. He also had an EMG/nerve conduction study (NCS), repetitive nerve stimulation (RNS), and single fiber EMG on day 1, all of which were within normal limits. Serum acetylcholine receptor antibody testing was obtained on admission, which was negative.Questions for consideration:

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Pharyngeal-cervical-brachial variant of Guillain-Barre syndrome

Cited by 111 publications

References 34 publications

Faecal Incontinence in Gullain-Barre Syndrome with Bulbar Palsy-A Case Report with Review of Literature

Faecal Incontinence in Gullain-Barre Syndrome with Bulbar Palsy-A Case Report with Review of Literature

Pharyngeal-Cervical-Brachial Variant of Guillain-Barre Syndrome

Clinical Reasoning: Oculobulbar dysfunction

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