A dysautonomia case of Guillain-Barré syndrome with recovery: monitored by Composite Autonomic Scoring Scale.

To investigate the usefulness of the Composite Autonomic Scoring Scale (CASS) as an indication for autonomic dysfunction with Guillain-Barré syndrome, we quantitated autonomic deficits on follow-up using CASS in a patient with Guillain-Barré syndrome who did not have any autonomic symptoms and had good clinical recovery. Using the CASS we found the patient to have mild autonomic dysfunction but with a period of recovery. The scale showed that adrenergic deficits improved quickly, sudomotor deficits recovered moderately and cardiovagal deficits did not improve. These results suggested that the patient with Guillain-Barré syndrome might have dysautonomia although she did not have any autonomic symptoms. Results also suggest that there might be difference on the degree of improvement among adrenergic, sudomotor and cardiovagal deficits in Guillain-Barré syndrome. The CASS may be a sensitive tool for the detection of autonomic dysfunction in Guillain-Barre syndrome.