Rare presentation of Guillain-Barre syndrome with complete heart block and neuropathic chest pain mimicking acute coronary syndrome: a case report

An 81-year-old woman presents with shortness of breath resulting in a diagnosis of picornavirus and complete heart block. Troponin was elevated and there was concern about acute coronary syndrome. The final diagnosis after echocardiogram and coronary angiogram was Takotsubo syndrome in addition to the heart block which required pacemaker insertion.

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Descending paralysis as an atypical presentation of Guillain–Barré Syndrome

SAGE Open Medical Case Reports ◽

10.1177/2050313x20986662 ◽

2021 ◽

Vol 9 ◽

pp. 2050313X2098666

Author(s):

Ala Mustafa ◽

Babajide Adio ◽

Alireza Yarahmadi

Keyword(s):

Case Report ◽

Lower Extremity ◽

Clinical Case ◽

Unusual Case ◽

Guillain Barre Syndrome ◽

Atypical Presentation ◽

Rare Presentation ◽

Guillain Barré Syndrome ◽

Guillain Barré ◽

Tendon Reflexes

We herein report a case of a 55-year-old man with an unusual case of Guillain–Barré Syndrome. Its presentation is usually a progression of symmetric muscle weakness that is ascending from the lower extremities making its way more proximal and accompanied by absent or depressed tendon reflexes. Here, the patient exhibited a rare presentation of Guillain–Barré syndrome, where the weakness was ascending upper extremity and descending lower extremity paralysis. The objective of this clinical case report is to highlight this extremely rare descending paralysis presentation of Guillain–Barré Syndrome.

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Case Report: Abnormal ECG and Pantalgia in a Patient With Guillain–Barré Syndrome

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.742740 ◽

2021 ◽

Vol 8 ◽

Author(s):

Xiangqi Cao ◽

Manyun Tang ◽

Hui Liu ◽

Xin Yue ◽

Guogang Luo ◽

...

Keyword(s):

Chest Pain ◽

Guillain Barre Syndrome ◽

Limb Weakness ◽

Coronary Syndrome ◽

Left Anterior Descending Artery ◽

Wave Inversion ◽

Guillain Barré Syndrome ◽

Sensory Disturbances ◽

Artery Disease ◽

Guillain Barré

Background: Guillain–Barré syndrome (GBS) is an acute immune-mediated disorder in the peripheral nervous system (PNS) characterized by symmetrical limb weakness, sensory disturbances, and clinically absent or decreased reflexes. Pantalgia and dysautonomia, including cardiovascular abnormalities, are common findings in the spectrum of GBS. It is usually challenging to distinguish GBS-related electrocardiogram (ECG) abnormities and chest pain from acute coronary syndrome (ACS) in patients with GBS due to the similar clinical symptom and ECG characteristics. Here, we present a case of GBS complicating ACS.Case Summary: A 37-year-old woman with a 2-month history of GBS presented to the emergency department due to pantalgia. The ECG showed a pattern of transitional T-wave inversion in the leads I, aVL, and V2 through V4 and shortly returned to normal, which appeared several times in a short time, but lab testing was unremarkable. Then, a further coronary computed tomography angiography (CTA) revealed the presence of critical stenosis of the left anterior descending artery, leading to the diagnosis of ACS. During the follow-up, she suffered from a non-ST-elevation myocardial infarction and accepted revascularization of the left anterior descending artery in the second week after discharge.Conclusion: Guillain–Barré syndrome could accompany chest pain and abnormalities on ECG. Meanwhile, it is essential to bear in mind that “GBS-related ECG abnormalities and chest pain” is a diagnosis of exclusion that can only be considered after excluding coronary artery disease, especially when concomitant chest pain, despite being a common presentation of pantalgia, occurs.

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A Case Report: Rare Presentation of Intracranial Hemorrhage post Guillain Barré Syndrome

International Journal of Clinical Research ◽

10.38179/ijcr.v1i1.23 ◽

2020 ◽

Vol 1 (1) ◽

pp. 109-112

Author(s):

Sarah El Halabi ◽

Jaafar Al Shami ◽

Ghadir Hijazi ◽

Zakaria Alameddine ◽

Maher Ghandour ◽

...

Keyword(s):

Case Report ◽

Intracranial Hemorrhage ◽

Ventilatory Support ◽

Respiratory Muscles ◽

Guillain Barre Syndrome ◽

Elderly Male ◽

Rare Presentation ◽

Unique Type ◽

Guillain Barré Syndrome ◽

Guillain Barré

Background: Guillain Barre Syndrome (GBS) is an autoimmune disease where antibodies attack the myelin sheath of peripheral nerves. The hallmark of the disease includes symmetrical quadriparesis, respiratory distress, and failure with subsequent need for mechanical ventilation. Most cases occur after a viral or bacterial infection. Other causes, such as intracranial hemorrhage, also exist, and several case studies report an association between these two pathologies. Case Report: In this report, we present the case of an elderly male patient with intracranial (IC) bleeding post-GBS. The patient was admitted to the hospital for dyspnea and diagnosed with pneumonia. When he started complaining of progressive bilateral ascending paralysis of his lower extremities, we performed a lumbar puncture, and he was diagnosed with GBS. We started him on intravenous immune globulins (IVIGs) immediately, but his weakness progressed to include his respiratory muscles, and he required mechanical ventilatory support with Intensive Care Unit (ICU) admission. We extubated him after two weeks, but he needed to be reintubated 24 hours later for a severely decreased level of consciousness. An urgent computed tomography scan of the brain showed IC bleeding. The patient developed a septic shock due to his pneumonia, which was refractory to antibiotics and vasopressors. He passed away a few weeks after that. Conclusion: Our case represents a unique type of association between IC hemorrhages and GBS, where the bleeding occurred several days after, as opposed to before GBS. It also reinforces the correlation between GBS and Intracranial bleeding and stresses the importance of having a high index of suspicion when facing either pathology since both have similar symptoms that may overlap or mask each other.

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A case report of Guillain Barré syndrome revealing underlying infective endocarditis due to Cardiobacterium hominis

Medicine ◽

10.1097/md.0000000000015014 ◽

2019 ◽

Vol 98 (15) ◽

pp. e15014

Author(s):

Kévin Diallo ◽

Caroline Jacquet ◽

Corentine Alauzet ◽

Isabelle Beguinot ◽

Thierry May ◽

...

Keyword(s):

Case Report ◽

Infective Endocarditis ◽

Guillain Barre Syndrome ◽

Guillain Barré Syndrome ◽

Guillain Barré

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Isolated facial diplegia: A rare presentation of Guillain‐Barre syndrome

Clinical Case Reports ◽

10.1002/ccr3.4473 ◽

2021 ◽

Vol 9 (7) ◽

Author(s):

Sundus Sardar ◽

Sreethish Sasi ◽

Suresh Menik Arachchige ◽

Muhammad Zahid ◽

Gayane Melikyan

Keyword(s):

Guillain Barre Syndrome ◽

Rare Presentation ◽

Facial Diplegia ◽

Guillain Barré Syndrome ◽

Guillain Barré

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Co-Occurrence of Guillain-Barre Syndrome and Multiple Sclerosis: A Rare Case Report

Dubai Medical Journal ◽

10.1159/000512773 ◽

2021 ◽

pp. 1-5

Author(s):

Amr Hassan ◽

Alaa El-Mazny ◽

Mohammed Saher ◽

Ismail Ibrahim Ismail ◽

Mohammed Almuqbil

Keyword(s):

Multiple Sclerosis ◽

Differential Diagnosis ◽

Case Report ◽

Rare Case ◽

Guillain Barre Syndrome ◽

Guillain Barré Syndrome ◽

Rare Case Report ◽

Central Nervous Systems ◽

Guillain Barré ◽

Demyelinating Disorders

Guillain-Barre syndrome (GBS) and multiple sclerosis (MS) are autoimmune demyelinating disorders of the peripheral and central nervous systems, respectively. The co-occurrence of these 2 conditions is rare in the literature. Herein, we present a rare case of GBS and MS in a 19-year-old female who presented initially with GBS followed by MS, and we provide a literature review. Despite being rare, it should be kept in mind in the differential diagnosis of patients with atypical and usual presentation of both diseases.

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