Fulminant Gullian-Baree syndrome mimicking cerebral death: case report

ABSTRACT

The Guillian-Baree syndrome [GBS] may present with a wide range of clinical pictures and many variants of typical syndrome are now recognized. Sporadic reports have described the occurrence of acute severe inflammatory polyneuropathy leading to a complete areflexic paralysis[2-3]. So, we described a patient that presented with a rapid course of neurological deterioration lapsing into what resembled a clinically brain-dead state that was subsequently ascribed to a fulminant polyneropathy. Investigations [electrophysiological and pathological] and the clinical course suggested an axonal neuropathy. A fulminant neuropathy can result in a clinical state resembling brain-death through diffuse differentiation, although generally attributed to aggressive demyelination with secondary axonal degeneration. A primary axonopathy can also lead to a similar clinical presentation. NB. This case was reported as the first case diagnosed in Farawnya Hospital and the first case reported in Kuwait