A Case Study Perspective: Navigating Guillain-Barre Syndrome

Abstract

Background. Guillain-Barre syndrome (GBS) is one of the primary causes of acute paralysis, which can potentially distress any age group of the human population. It is a rare but serious post-infectious, immune-mediated neuropathy, resulting from the autoimmune destruction of nerves in the peripheral nervous system. Several infections have been linked with GBS, the most common being gastrointestinal and respiratory illnesses. Up to 70% of patients have reported an antecedent illness in the 1 to 6 weeks before the presentation of GBS. Despite the current understanding of the pathophysiology and available treatment options, the morbidity and mortality associated with GBS is quite high.  Patient concerns and findings. Here, we present a case from a tertiary care hospital, where a 16-year-old boy presented with presented with sudden onset bilateral lower limb weakness, immobility, dysphagia, fever, cough and bowel incontinence. Main diagnosis, interventions and outcomes. The CNS examination suggested diminished reflexes, tone, complete absence of power in all the limbs and facial nerve palsy. Pleural effusion and spinal cord edema were other investigative observations. These led to the diagnosis of Guillain-Barre syndrome, with lower respiratory tract infection. The patient was immediately transferred to the intensive care unit, wherein the necessary antimicrobials were initiated. This was followed by five cycles of plasmapheresis with a successful outcome. Conclusion. Although the patient response was satisfactory, vigorous monitoring for comorbidities and secondary infections should be necessitated.