# Case Report: AMSAN variant of GBS complicating immediate postpartum period with severe dysautonomia leading to Posterior Reversible Encephalopathy Syndrome

## TL;DR

A woman developed a rare form of GBS after childbirth, leading to severe neurological complications and PRES, but she recovered well with treatment.

## Contribution

This case report highlights the rare AMSAN variant of GBS in the postpartum period complicated by PRES.

## Key findings

- The patient developed acute flaccid quadriparesis and breathing difficulty, consistent with GBS.
- She later developed PRES, diagnosed via MRI and clinical symptoms, which resolved with treatment.
- The patient made a good recovery and regained independence in daily activities.

## Abstract

A 20’s primiparous woman, following spontaneous expulsion of intrauterine death of the fetus at 30 weeks of gestation, presented on post-partum day 8 with acute onset flaccid quadriparesis and breathing difficulty, which had rapidly progressed to involve the legs on day 3 up to her upper limbs on post-partum day 5. Following examination, Guillain Barre Syndrome (GBS) with ascending diaphragmatic involvement was diagnosed, and plasma exchange was initiated. She developed raised blood pressure, headache, sudden onset visual loss with 2 episodes of generalized seizures on post-partum day 14. Brain MRI and clinical suspicion helped diagnose Posterior Reversible Encephalopathy Syndrome (PRES). The patient was treated with anticonvulsants and antihypertensive agents. She regained her vision over the next two days, completed the treatment for GBS, and made a good recovery with independence for advanced activities of daily living on follow-up.