# Case Report: Guillain–Barré syndrome with three episodes and literature review

## TL;DR

A 49-year-old man experienced three episodes of Guillain–Barré syndrome, a rare autoimmune condition affecting the nerves, and recovered after treatment with immunoglobulin.

## Contribution

This case report highlights a rare instance of Guillain–Barré syndrome recurring three times in a single patient.

## Key findings

- The patient had three episodes of bilateral lower extremity numbness and weakness, each reaching its worst within 4 weeks.
- Anti-sulfatide IgG antibodies were detected during the third episode, supporting the GBS diagnosis.
- Treatment with intravenous immunoglobulin led to nearly complete resolution of symptoms.

## Abstract

Guillain–Barré syndrome (GBS) is an autoimmune-mediated peripheral neuropathy that is usually monophasic, but recurrence occurs in 2%–5% of cases, termed recurrent Guillain–Barré syndrome (RGBS). We report the case of a 49-year-old male patient who experienced three episodes of bilateral lower extremity numbness and weakness, each progressing to its nadir within 4 weeks. The first episode was additionally characterized by bilateral upper extremity weakness and dyspnea, while the first two episodes were accompanied by numbness in the fingertips of both hands. Electromyography (EMG) revealed severe axonal damage with concomitant demyelination. Anti-sulfatide IgG antibodies were detected during the third episode. After excluding other demyelinating disorders, a definitive diagnosis of GBS was established, and the symptoms were nearly completely resolved following treatment with intravenous immunoglobulin (IVIG).