Gawhale Siddhi, Tambolkar Sampada, Patil Manojkumar G, Vonteru Poornima, Mane Shailaja
Pediatrics, Dr. D. Y. Patil Medical College, Hospital and Research Center, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.
Pediatric Neurology, Dr. D. Y. Patil Medical College, Hospital and Research Center, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.
Cureus. 2024 Oct 8;16(10):e71057. doi: 10.7759/cureus.71057. eCollection 2024 Oct.
Guillain-Barré syndrome (GBS) is an immune-mediated demyelinating disease; weakness is typically ascending in nature with areflexia. Any deviation from this typical course becomes a diagnostic challenge with variable prognosis. Here, we report cases of GBS presenting with rapidly evolving descending weakness with predominant bulbar involvement and dysautonomia as an atypical presentation, which can lead to delay in diagnosis and treatment. We also highlight how atypical GBS are slow responders to immunomodulation therapy like intravenous immunoglobulin (IVIG) and plasma exchange, and hence, a multidisciplinary approach would modify the outcome.
吉兰-巴雷综合征（GBS）是一种免疫介导的脱髓鞘疾病；肌无力通常呈上行性发展且伴有反射消失。任何偏离这种典型病程的情况都会成为诊断难题，预后也各不相同。在此，我们报告GBS病例，其表现为迅速进展的下行性肌无力，以延髓受累为主，并伴有自主神经功能障碍，这是一种非典型表现，可能导致诊断和治疗延迟。我们还强调，非典型GBS对静脉注射免疫球蛋白（IVIG）和血浆置换等免疫调节治疗反应缓慢，因此，多学科方法会改善治疗结果。
