A Rare Case of An Oculopharyngeal Subtype of Guillain-Barré Syndrome

Abstract

Cranial nerve involvement in Guillain-Barré syndrome (GBS) is a rare but clinically significant manifestation that presents unique diagnostic challenges. We report the case of an 18-year-old female patient with a history of gastroenteritis who developed bilateral ptosis, horizontal diplopia, swallowing difficulties, facial diplegia, and tongue protrusion defects over 10 days. Neurological examination revealed multiple cranial nerve involvement, with normal cerebral MRI findings and absent albuminocytological dissociation in cerebrospinal fluid analysis. Electromyography showed pathological findings in the cranial nerves, while serum anti-ganglioside antibodies were negative. Diagnosed with the oculopharyngeal variant of GBS, the patient underwent plasma exchange and immunoglobulin therapy, resulting in slight improvement after three months, yet persistent deficits remained. This case highlights the complexity and variability of GBS presentations, particularly the importance of considering cranial polyneuritis in patients with preceding infectious symptoms. Further studies are needed to explore optimal treatment strategies and the underlying mechanisms of this rare variant.