ABSTRACT
Dengue is a common mosquito-borne infection in India. We reported a rare Pharyngeal cervical brachial (PCB) variant of Landry Guillain Barre syndrome (LGBS) associated with the dengue virus infection. The pathogenesis seems to be molecular mimicry between gangliosides and microbial lipo-oligosaccharides. PCB usually presents with oropharyngeal or cervicobrachial weakness. Therefore, it must be recognised early and distinguished from conditions presenting with cephalocaudal progressing weakness, such as Myasthenia Gravis, Miller-Fisher syndrome, botulism, diphtheria, porphyria or brain stem stroke. The aim of the study was to add to the limited literature on the PCB variant of LGBS after dengue infection and shed some light on presentation and management options for this rare entity.
ABSTRACT
A Síndrome de Guillain-Barré (SGB) é uma polineuropatia autolimitada, na maioria das vezes de mecanismo autoimune pós-infeccioso. Este caso tem por objetivo relatar uma variante rara do espectro da SGB. O método utilizado foi o acompanhamento clínico do paciente e revisão de prontuário. Conclui-se que conhecimento acerca da FCB e alto grau de suspeição são importantes para o diagnóstico diferencial de pacientes que apresentam sintomas bulbares e fraqueza de membros superiores, principalmente pela gama de diagnósticos diferenciais que os sintomas podem sugerir.
Guillain-Barré syndrome (GBS) is a self-limited polyneuropathy, most often by a post-infectious autoimmune mechanism. This case aims at reporting a rare variant of the GBS spectrum. The method used was clinical monitoring of the patient and medical record review. It was concluded that knowledge of the pharyngeal-cervical-brachial variant and high degree of suspicion are important for the differential diagnosis of patients with bulbar symptoms and weakness of the upper limbs, particularly because of the range of differential diagnoses the symptoms may suggest.
Subject(s)
Humans , Polyradiculoneuropathy , Guillain-Barre SyndromeABSTRACT
El síndrome de Guillain-Barré es una polineuropatía desmielinizante inflamatoria aguda, existiendo variantes locorregionales poco frecuentes como la faringo-cérvico-braquial. Presentamos el caso de un varón de 63 años de edad que acudió a urgencias por debilidad de extremidades superiores y a nivel cervical, con incapacidad para deglutir y masticar, y una insuficiencia respiratoria aguda rápidamente progresiva por debilidad de músculos respiratorios, todo ello secundario a la variante faringo-cérvico-braquial del síndrome de Guillain-Barré. Esta variante, aunque poco frecuente, presenta un patrón clínico y unos criterios diagnósticos bien definidos, importantes de reconocer para poder así iniciar de forma precoz el tratamiento y mejorar el pronóstico, no siempre favorable, de estos pacientes.
Guillain-Barré syndrome is an acute inflammatory demyelinating polyneuropathy. Infrequent loco-regional variants, like the pharyngeal-cervical-brachial, have been described. We report the case of a 63-year-old male admitted to the emergency department with cervical and upper limb weakness, inability to swallow and chew, he also presented a rapidly progressive acute respiratory failure due to weakness of the respiratory muscles secondary to the pharyngeal-cervical-brachial variant of Guillain-Barré syndrome. This variant, although unusual, presents a well-defined clinical pattern and diagnostic criteria, which is important in order to start an early treatment to improve the prognosis, not always favorable, to these patients.