Location
Suwanee, GA
Start Date
6-5-2025 1:00 PM
End Date
6-5-2025 4:00 PM
Description
Introduction
Guillain-Barré Syndrome (GBS) is a rare, immune-mediated polyneuropathy that typically presents with ascending muscle weakness and areflexia. However, atypical features can obscure diagnosis, leading to delays in treatment. Primary care physicians (PCPs) often serve as the first point of contact for patients with evolving neurological symptoms. This case illustrates an unusual presentation of GBS with hyperreflexia and no preceding infection, highlighting key diagnostic challenges for PCPs in recognizing non-classical cases early.
Case Description
A 35-year-old female with asthma and depression presented with three weeks of progressive weakness, tremors, and blurred vision, beginning two days after a camping trip. Initial workup, including Lyme titers and inflammatory markers, was unremarkable. Despite a 12-day steroid trial, her symptoms worsened. Examination revealed hyperreflexia, tremors, and proximal weakness—findings atypical of GBS. After multiple evaluations, cerebrospinal fluid analysis and MRI confirmed the diagnosis. She was treated with a five-day course of IVIG, leading to significant improvement. Early respiratory monitoring and rehabilitation were initiated to prevent complications.
Discussion & Conclusion
This case underscores the importance of recognizing atypical GBS presentations in primary care and emergency settings. Hyperreflexia and an absence of preceding infection can lead to misdiagnosis. PCPs and emergency physicians should maintain a high index of suspicion and initiate early neurological evaluation, including cerebrospinal fluid analysis and nerve conduction studies. Prompt treatment with IVIG or plasmapheresis, along with multidisciplinary management, is crucial for improving patient outcomes.
Embargo Period
5-28-2025
Included in
Atypical Presentation of Guillain-Barré Syndrome
Suwanee, GA
Introduction
Guillain-Barré Syndrome (GBS) is a rare, immune-mediated polyneuropathy that typically presents with ascending muscle weakness and areflexia. However, atypical features can obscure diagnosis, leading to delays in treatment. Primary care physicians (PCPs) often serve as the first point of contact for patients with evolving neurological symptoms. This case illustrates an unusual presentation of GBS with hyperreflexia and no preceding infection, highlighting key diagnostic challenges for PCPs in recognizing non-classical cases early.
Case Description
A 35-year-old female with asthma and depression presented with three weeks of progressive weakness, tremors, and blurred vision, beginning two days after a camping trip. Initial workup, including Lyme titers and inflammatory markers, was unremarkable. Despite a 12-day steroid trial, her symptoms worsened. Examination revealed hyperreflexia, tremors, and proximal weakness—findings atypical of GBS. After multiple evaluations, cerebrospinal fluid analysis and MRI confirmed the diagnosis. She was treated with a five-day course of IVIG, leading to significant improvement. Early respiratory monitoring and rehabilitation were initiated to prevent complications.
Discussion & Conclusion
This case underscores the importance of recognizing atypical GBS presentations in primary care and emergency settings. Hyperreflexia and an absence of preceding infection can lead to misdiagnosis. PCPs and emergency physicians should maintain a high index of suspicion and initiate early neurological evaluation, including cerebrospinal fluid analysis and nerve conduction studies. Prompt treatment with IVIG or plasmapheresis, along with multidisciplinary management, is crucial for improving patient outcomes.