Hyperreflexic Guillain - Barre Syndrome: A Rare Case Report and a Brief Review of Literature

Title: Hyperreflexic Guillain - Barre Syndrome: A Rare Case Report and a Brief Review of Literature

Authors: Dr Vajed Mogal, Dr Sandeep Sanap, Dr Pratik Patil, Dr Preetam Ahire

DOI: http://dx.doi.org/10.18535/jmscr/v3i10.26

Abstract

References

Corresponding Author

Abstract

Guillain–Barre syndrome (GBS) is a common cause of acute peripheral neuropathy and is characterized by hyporeflexia or areflexia. Hyperreflexia has been rarely reported with acute motor axonal neuropathy. A 65 year-old-female, known case of hypertension with type 2 diabetes mellitus, presented with asymmetrical weakness of upper and lower limbs and slurring of speech. Weakness progressed in the hospital with involvement of multiple cranial nerves, preserved deep tendon jerks with extensor plantar, and normal abdominal reflexes. She was treated with IV immunoglobulin and IV methylprednisolone. She was able to walk with support with normal voice at the time of discharge. This case reports highlights hyperreflexic guillain-barre syndrome as a rare presentation.

Key Words: Guillain–Barre syndrome(GBS), Quadriparesis, Hyperreflexia, Acute motor axonal neuropathy (AMAN)

References

1. Kuwabara S, Ogawara K, Koga M, Mori M, Hattori T, Yuki N. Hyperreflexia in Guillain- Barré syndrome: Relation with acute motor axonal neuropathy and anti- GM1 antibody. J Neurol Neurosurg Psychiatry. 1999;67:180–4.

2. McKhann GM, Cornblath DR, Griffin JW, Ho TW, Li CY, Jiang Z, et al. Acute motor axonal neuropathy: A frequent cause of acute flaccid paralysis in China. Ann Neurol. 1993;33:333–42.

3. Gupta D, Nair M, Baheti NN, Sarma PS, Kuruvilla A. Electrodiagnostic and clinical aspects of Guillain- Barré syndrome: An analysis of 142 cases. J Clin Neuromuscul Dis. 2008;10:42–51.

4. Somarajan A. Guillain Barre syndrome with brisk reflexes—Another variant. Neurol India. 2006;54:215–6.

5. Inés GS, Irene SG, Francisco JRR, Javier A. Guillain- Barré Syndrome: Natural history and prognostic factors: a retrospective review of 106 cases. BMC Neurology 2013; 13:95.

6. Asbury AK: Diagnostic considerations in Guillain-Barre syndrome. Ann Neurol 1981, 9(Suppl):1

7. Ropper AH: The Guillain-Barre syndrome. N Engl J Med 1992, 326(17):1130-1136.

8. Susuki K, Astumi M, Koga M, Hirata K, Yuki N. Acute facial diplegia and hyperreflexia- A Guillain Barre Syndrome variant. Neurology. 2004;62:825–7.

9. Capasso M, Caporale CM, Pomilio F, Gandolfi P, Lugaresi A, Uncini A. Acute motor conduction block neuropathy.Another Guillain- Barre syndrome variant. Neurology. 2003;61:617–22.

10. Van der Meché FG, Meulstee J, Vermeulen M, Kievit A. Patterns of conduction failure in the Guillain- Barré syndrome. Brain. 1988;111:405–16.

11. Jacobs BC, Rothbarth PH, van der Meché FG, Herbrink P, Schmitz PI, de Klerk MA, et al. The spectrum of antecedent infections in Guillain-Barre syndrome: A case-control study. Neurology 1998; 51:1110–5.

12. Sokrab TO, Eltahir A et al. Guillain-Barré syndrome following acute falciparum malaria. Neurology 2002; 59: 1281-3.

13. Schonberger LB, Hurwitz ES, Katona P et al. Guillain-Barré syndrome: it epidemiology and association with influenza vaccination. Ann Neurol 1981; 9 (suppl): 31-8.

14. Wijesundere A. Guillain-Barré syndrome in Plasmodium falciparum malaria. Postgrad Med J 1992; 68: 367-77.

15. Shubhakaran, Sharma CM. Acute inflammatory demyelinating polyneuropathy with P. falciparum malaria. JAPI 2003; 51: 223-4.

16. Singh NK, Jaiswal AK, Misra S, Srivastava PK: Assessment of autonomic dysfunction in Guillain-Barre syndrome and its prognostic implications. Acta Neurol Scand 1987, 75(2):101-105.

17. Zochodne DW: Autonomic involvement in Guillain-Barre syndrome: a review. Muscle Nerve 1994, 17(10):1145-1155.

18. Osler W: The principles and practice of Medicine. New York. Appleton-Century-Crofts; 1899.

19. Pfeiffer G, Schiller B, Kruse J, Netzer J: Indicators of dysautonomia in severe Guillain-Barre syndrome. J Neurol 1999, 246(11):1015-1022.

20. Flachenecker P, Toyka KV, Reiners K: Cardiac arrhythmias in Guillain-Barre syndrome. An overview of the diagnosis of a rare but potentially life-threatening complication. Nervenarzt 2001, 72(8):610-617.

21. Greenland P, Griggs RC: Arrhythmic complications in the Guillain-Barre syndrome. Arch Intern Med 1980, 140(8):1053-1055.

22. Yuki N, Hartung H. Review article: medical progress in Guillain Barre Syndrome. N Engl J Med 2012; 366: 2294-304.

23. National Institute of Neurological Disorders and Stroke. NINDS Guillain-Barré syndrome information page. National Institute of Neurological Disorders and Stroke; 2011. Available from: www.ninds.gov/ disorders/gbs/gbs.htm

24. Sejvar J, Kohl K, Gidudu J, Amato A, Bakshi N, Baxter R et al. Guillain-Barré syndrome and Fisher syndrome: case definitions and guidelines for collection, analysis, and presentation of immunization safety data. Vaccine 2011; 29: 599–612.

25. Seneviratne U. Guillain-Barré syndrome. Postgrad Med J 2000; 76: 774–82.

26. Gordon PH, Wilbourn AJ. Early electrodiagnostic findings in Guillain- Barré syndrome. Arch Neurol. 2001;58:913–7.

27. Brown WF, Feasby TE. Conduction block and denervation in Guillain- Barré polyneuro- pathy. Brain. 1984;107:219–39.

28. Rostásy KM, Huppke P, Beckers B, Brockmann K, Degenhardt V, Wesche B et al. Acute motor and sensory axonal neuropathy (AMSAN) in a 15-year-old boy presenting with severe pain and distal muscle weakness. Neuropediatrics 2005; 36: 260-4.

29. Hughes RA, Wijdicks EF, Benson E, Cornblath DR, Hahn AF, Meythaler JM et al. Supportive care for patients with Guillain-Barré syndrome. Arch Neurol 2005; 62: 1194-8.

30. Rees JH, Soudain SE, Gregson NA, Hughes RA. Campylobacter jejuni infection and Guillain-Barré syndrome. N Engl J Med 1995; 333: 1374-9.

31. Walgaard C, Lingsma HF, Ruts L, van Doorn PA, Steyerberg EW, Jacobs BC. Early recognition of poor prognosis in Guillain-Barre syndrome. Neurology 2011; 76: 968.

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Call For Paper Volume 12 Issue 10 November 2024

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