An Acute Pharyngeal-Cervical-Brachial Variant of Guillain-Barre Syndrome Manifesting as Isolated Bulbar Palsy
Published: May 1, 2020 | DOI: https://doi.org/10.7860/JCDR/2020/43820.13715
Ayan Husain, Apoorva Nirmal, Parag Aradhey, Sourya Acharya
1. Resident Doctor, Department of Medicine, Jawaharlal Nehru Medical College, Wardha, Maharashtra, India.
2. Resident Doctor, Department of Medicine, Jawaharlal Nehru Medical College, Wardha, Maharashtra, India.
3. Neurologist, Department of Medicine, Jawaharlal Nehru Medical College, Wardha, Maharashtra, India.
4. Professor, Department of Medicine, Jawaharlal Nehru Medical College, Wardha, Maharashtra, India.
Correspondence
Dr. Ayan Husain,
Flat No. A-3, 2nd Floor, Vishwakarma Apts, Paloti Road, Sawangi-442001, Wardha, Maharashtra, India.
E-mail:ayanhusain123@gmail.com
Guillain Barre Syndrome (GBS) is characterised by acute onset ascending quadriparesis with areflexia. One of its rare variants is the Pharyngeal-Cervical-Brachial (PCB) variant which is characterised by acute weakness of the oropharyngeal, neck, and shoulder muscles with swallowing dysfunction. Here, the authors report a case of 57-year-old female, who presented with sudden onset dysphagia and nasal voice without having any limb weakness. Examination revealed reduced reflexes and weak palatal and pharyngeal muscles. Cerebrospinal Fluid (CSF) examination showed an albumino-cytological dissociation and nerve conduction studies revealed demyelinating motor polyneuropathy. A test for anti-GT1a antibody was positive. These findings were consistent with GBS. However, the patient presented only with bulbar involvement which is likely to be the milder form of the rare PCB variant. The patient recovered with plasmapheresis and was discharged in around three weeks. We conclude that GBS should be considered as differential diagnosis in a patient with isolated bulbar palsy.
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