Guillain-Barré Syndrome Presenting With Bulbar Symptoms: A Case Report

TL;DR

This case report describes a patient with Guillain-Barré Syndrome who initially showed non-specific symptoms like dizziness and weakness, later developing bulbar symptoms such as difficulty swallowing.

Contribution

The novelty lies in highlighting the atypical and subtle early presentation of GBS with bulbar symptoms, emphasizing the importance of a multidisciplinary approach in diagnosis and management.

Findings

The patient's initial symptoms were vague and non-specific, delaying initial recognition of GBS.

Early bulbar symptoms such as difficulty swallowing and slurred speech were observed and progressed over time.

A multidisciplinary approach was crucial in diagnosing and managing the patient's GBS.

Abstract

Guillain-Barré syndrome (GBS) is an acute, immune-mediated neuropathy characterized by rapidly progressive, symmetrical weakness, areflexia, and variable sensory loss. It is often triggered by preceding respiratory or gastrointestinal infection through a mechanism of molecular mimicry, leading to demyelination or axonal injury. Diagnosis is supported by cerebrospinal fluid albumin-cytologic dissociation and nerve conduction studies. Early initiation of intravenous immunoglobulin or plasma exchange, alongside vigilant supportive care, reduces morbidity and prevents complications such as respiratory failure and autonomic instability. In this case report, we describe a patient presenting with vague and non-specific symptoms, including dizziness and lower back pain while walking, generalized weakness, and early bulbar symptoms such as difficulty swallowing and slurred speech. These early manifestations, though subtle, gradually progressed and prompted further evaluation, highlighting the stepwise diagnostic process, targeted investigations, and the multidisciplinary team approach that guided his medical management of GBS.

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