AJNN
Academic Journal of Neurology and Neurosurgery

The Academic Journal of Neurology and Neurosurgery deals with Neurology and Neurosurgery accepts articles on these topics. Academic Journal of Neurology and Neurosurgery publishes original research articles, review articles, case reports, editorial commentaries, letters to the editor, educational articles, and conference/meeting announcements.

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Case Report
Multiple cranial nerves involvement as initial presentation of Guillain-Barré syndrome
Abstract
Guillain-Barré syndrome is an immune-mediated peripheral nerve disease with classical symptoms of progressive ascending bilateral upper and lower limb weakness. Cranial nerves involvement can be part of manifestation of Guillain-Barré syndrome. Case reports on early involvement of multiple cranial nerves in this disease are limited. We hereby describe a 49 year old man who was diagnosed as Guillain-Barré syndrome presenting unusually with facial diplegia and bulbar palsy that preceded lower limbs weakness and paresthesia. The diagnosis was supported with rare neuroimaging findings of bilateral facial nerves enhancement. He recovered well with supportive management.

Keywords : Guillain-Barré Syndrome, facial diplegia, bulbar palsy, cranial nerves

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1. Aravind SM, Karri VPVR, Suganya K, Tumbanatham A. Facial diplegia as an initial presentation of Guillain-Barré syndrome. J Clin Diagn Res. 2023;17(4):OD04-6. doi:10.7860/JCDR/2023/60781.17720
2. Susuk K, Koga M, Hirata K, Isogai E, Yuki N.A Guillain-Barré syndrome variant with prominent facial diplegia.J Neurol. 2009;256: 1899-1905. doi:10.1007/s00415-009-5254-8
3. Michael TA, Joyce LO, Kelly M, Rashida YW. Guillain-Barré syndrome clinical presentation: history, physical examination. Medscape. https://emedicine.medscape.com/article/315632-clinical#:~:text=Cranial%20nerve%20involvement%20is%20observed,droop%20(may%20mimic%20Bell%20palsy). Updated July 29, 2024.Accessed December 11, 2024.
4. Bhargava A, Banakar BF, Pujar GS, Khichar S. A study of Guillain-Barré syndrome with reference to cranial neuropathy and its prognostic implication. J Neurosci Rural Pract. 2014;5(Suppl 1):S43-47. doi:10. 4103/0976-3147.145200
5. Rodríguez-Méndez AA, Briseño-Ramírez J, Rivas-Ruvalcaba FJ, et al. Clinical predictors for mechanical ventilation assistance in Guillain-Barré syndrome. Front Neurol. 2024;15:1385945. doi:10.3389/fneur. 2024.1385945
6. Maskin LP, Wilken M, Lucci FR, et al. Risk factors for respiratory failure among hospitalized patients with Guillain-Barré syndrome. Neurologia (Engl Ed). 2024;39(1):36-42. doi:10.1016/j.nrleng.2023.12.004
7. Yardimci N, Avci AY, Kayhan E, Benli S. Bilateral facial nerve enhancement demonstrated by magnetic resonance imaging in Guillain-Barré syndrome. Neurol Sci. 2009;30(5):431-433. doi: 10.1007/s10072-009-0120-0
8. Fulbright RK, Erdum E, Sze G, Byrne T. Cranial nerve enhancement in the Guillain-Barré syndrome. AJNR Am J Neuroradiol. 1995;16(4 Suppl):923-925.
9. Barsheshet A, Marai I, Appel S, Zimlichman E. Acute ST elevation myocardial infarction during intravenous immunoglobulin infusion. Ann N Y Acad Sci. 2007;1110:315-318. doi:10.1196/annals.1423.033.
10. Verboon C, van Doorn PA, Jacobs BC. Treatment dilemmas in Guillain-Barré syndrome. J Neurol Neurosurg Psychiatry. 2017;88(4):346-52. doi: 10.1136/jnnp-2016-31486
Article available in :
Volume 2, Issue 1, 2025
Page : 16-18
https://doi.org/10.51271/AJNN-0025
Article Information
Received : 10 Ara 2024
Accepted : 16 Oca 2025
Published : 21 Mar 2025
Corresponding Author :

Wai Hou Khuan: Department of Neurology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia

[email protected]
Citation : Khuan WH, Krishnan D, Ahmad RARRL, Sankala HA. Multiple cranial nerves involvement as initial presentation of Guillain-Barré syndrome. Acad J Neurol Neurosurg. 2025;2(1):16-19.

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