Recurrent Guillain-Barré Syndrome: A Case Report and Literature Review

TL;DR

A 66-year-old woman experienced three episodes of Guillain-Barré syndrome, highlighting the rare recurrence of this condition and the importance of accurate diagnosis and treatment.

Contribution

This case report adds to the understanding of recurrent Guillain-Barré syndrome and emphasizes the need to differentiate it from similar conditions.

Findings

The patient had three episodes of Guillain-Barré syndrome with similar clinical and diagnostic features.

Treatment with intravenous immunoglobulin led to partial recovery and near-complete resolution at follow-up.

Anti-ganglioside antibodies were detected in the current episode, aiding in diagnosis.

Abstract

Guillain-Barré syndrome (GBS) is an acute polyradiculoneuropathy, which is generally considered to be monophasic, but recurrences can occur in rare cases. A 66-year-old lady presented with complaints of bilateral lower limb weakness progressing to bilateral upper limb involvement over 20 days. The examination revealed lower limb weakness and absent deep tendon reflexes. She had a history of two similar episodes, diagnosed as GBS, with nerve conduction studies showing demyelinating polyneuropathy and elevated protein in the cerebrospinal fluid. The current episode revealed identical findings, along with positive anti-ganglioside antibodies. She was treated with intravenous immunoglobulin (IVIG) and physiotherapy, resulting in partial recovery at discharge three weeks after symptom onset and near-complete resolution at the three-month follow-up. This case enriches the understanding of recurrent GBS and the importance of differentiating it from treatment-related fluctuation and or chronic inflammatory demyelinating polyneuropathy with acute onset. It further sheds light upon diagnostic interventions and recent advances in management.

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