Reversible conduction failure in pharyngeal‐cervical‐brachial variant of guillain‐barré syndrome

Abstract

In two patients with the pharyngeal-cervical-brachial variant (PCB) of Guillain-Barré syndrome (GBS), low amplitude distal compound muscle action potentials and partial motor conduction blocks normalized without development of excessive temporal dispersion within 4 weeks. Sensory nerve action potentials significantly improved in amplitude or, when absent, rapidly became recordable at follow-up. Besides axonal degeneration, PCB is characterized by reversible conduction failure in both motor and sensory fibers and is in the continuous spectrum of axonal GBS subtypes.

Non-demyelinating, reversible conduction failure in a case of pharyngeal–cervical–brachial weakness overlapped by Fisher syndrome

“…NCS findings in PCB and FS patients have been variably reported, suggesting demyelinating or axonal neuropathies [19][20][21]. Recent reports where serial NCS were performed have shown patterns suggesting axonal conduction failure [19,20]. Together with these reports, our case suggests that PCB, FS and PCB/FS fall in a continuous spectrum with axonal GBS subtypes.…”

“…One reported poor persistence of median and peroneal F-responses, and bilateral delayed second component of the blink reflex, while the other had mild reduction in sensory amplitudes [2,14]. NCS findings in PCB and FS patients have been variably reported, suggesting demyelinating or axonal neuropathies [19][20][21]. Recent reports where serial NCS were performed have shown patterns suggesting axonal conduction failure [19,20].…”

Motor and sensory conduction failure in overlap of Guillain–Barré and Miller Fisher syndrome: Two simultaneous cases

“…RCF is thought to be due to a transitory limited attack of antiganglioside antibodies at the axolemma of the nodes of Ranvier not progressing to axonal degeneration [4,7,8]. More recently RCF has also been described in sensory fibers and other GBS variants such as acute sensory ataxic neuropathy and the pharyngeal-cervical-brachial (PCB) variant [9][10][11]. MFS is for its part, usually associated with virtually exclusive axonal sensory loss, electrophysiologically [12][13][14].…”

Clinical Reasoning: Oculobulbar dysfunction

“…[3][4][5] This pathology can theoretically arrest at this stage with a functional improvement or, as in our case, can progress to axonal degeneration. 5,6 We tested serum anti-GT1a antibodies as prior studies have described patients with anti-GT1a antibody presenting clinically with PCB/MFS. 7 However, the test was negative.…”