Randhawa Jasneet, Randhawa Harneet S, Toor Prabhdeep
Medicine, Fortis Escorts Hospital, Amritsar, IND.
Radiology, Government Medical College & General Hospital, Baramati, Baramati, IND.
Cureus. 2021 Sep 13;13(9):e17945. doi: 10.7759/cureus.17945. eCollection 2021 Sep.
Guillain-Barré syndrome (GBS) has an annual incidence rate ranging from 0.4 to 1.7 cases per 1,00,000 population. Pharyngeal-cervical-brachial (PCB) variant is an extremely rare variant of GBS (3%), which presents with muscle weakness initially involving the neck, oropharynx, and upper extremities. GBS often has an infectious inciting event leading to an autoimmune response. There has been an increase in the incidence of GBS during the COVID-19 pandemic, and several case studies have shown an association between the development of GBS and COVID-19 infection. High clinical suspicion is needed to reach a diagnosis. As PCB variant of GBS can have fatal outcomes, a good clinical knowledge of its presentation can allow timely life-saving interventions. Here, we report a case of GBS with acute onset of neck and respiratory muscle weakness that progressed to upper limb weakness. The patient developed these symptoms two weeks after the onset of cough, fever, and malaise. PCB variant of GBS should always be considered as an important differential diagnosis in any patient presenting with limb weakness and bulbar palsy.
吉兰-巴雷综合征（GBS）的年发病率为每10万人中0.4至1.7例。咽颈臂型（PCB）变异型是GBS的一种极其罕见的变异型（3%），其表现为肌肉无力，最初累及颈部、口咽和上肢。GBS通常有一个感染性诱发事件，导致自身免疫反应。在新冠疫情期间，GBS的发病率有所上升，多项病例研究表明GBS的发生与新冠病毒感染之间存在关联。需要高度的临床怀疑才能做出诊断。由于GBS的PCB变异型可能会导致致命后果，对其临床表现有良好的临床认识可以及时进行挽救生命的干预。在此，我们报告一例GBS病例，该病例急性起病，颈部和呼吸肌无力，随后进展为上肢无力。患者在咳嗽、发热和不适发作两周后出现这些症状。对于任何出现肢体无力和延髓麻痹的患者，GBS的PCB变异型都应始终被视为重要的鉴别诊断。
