Intracranial Hemorrhage in a Patient With Guillain-Barré Syndrome: A Potential Complication, a Coincidental Finding or a Treatment-Related Complication

TL;DR

This case report highlights the challenges of managing a rare variant of Guillain-Barré syndrome and a rare complication of intracranial bleeding.

Contribution

The paper presents a rare case of intracranial hemorrhage in a patient with PCB variant of GBS.

Findings

The patient developed intracranial bleeding 11 days after hospitalization and six days after IVIG treatment.

PCB syndrome should be considered in patients with bilateral upper limb weakness and oropharyngeal involvement.

Close monitoring is essential to manage life-threatening complications like ICH in PCB patients.

Abstract

This case report demonstrates the difficulty of diagnosing and managing the pharyngeal-cervical-brachial (PCB) variant of Guillain-Barré syndrome (GBS), as well as the rare complication of intracerebral hemorrhage (ICH). A male patient in his mid-60s, presented with bilateral upper limb weakness, bilateral ptosis, and bulbar symptoms. The clinical presentation combined with paraclinical findings supported the diagnosis of PCB. During the course of PCB, the patient required tracheostomy and gastrostomy due to the worsening of his symptoms. Eleven days after hospitalization, and six days after the course of intravenous immunoglobulin (IVIG), the patient developed intracranial bleeding. All clinicians should consider the PCB syndrome in patients with bilateral upper extremity weakness and oropharyngeal involvement, in order to develop a personalized treatment plan and closely monitor potential life-threatening complications such as ICH.

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