Atypical Guillain-Barré syndrome presenting with fluctuating weakness

Lauren L. Crowther, Amarjyot K. Randhawa, Robert W. Plambeck

Research output: Contribution to journalArticlepeer-review


Guillain-Barré Syndrome (GBS) is an immune-mediated polyneuropathy, most often occurring within weeks of an infection. Cases of COVID-19–related GBS have been reported, and the typical presentation is a progressive ascending paralysis. We describe a case of a 40-year-old with recent symptomatic COVID-19 who presented with atypical GBS findings, hand weakness that progressed to tetraplegia within 24 hours. He had hyperreflexia on his initial exam and did not meet diagnostic criteria for GBS. Inconsistent neurological findings with spontaneous improvement of symptoms, unremarkable initial evaluation including lumbar puncture, and anxiety further complicated the diagnosis. On day 6, he was intubated for diaphragmatic paralysis, and repeat lumbar puncture showed albumin-cytologic dissociation. Intravenous immunoglobulin followed by plasmapheresis improved strength and allowed for extubation. This case highlights the difficulty of recognizing heterogenic GBS presentations.

Original languageEnglish (US)
Pages (from-to)111-113
Number of pages3
JournalBaylor University Medical Center Proceedings
Issue number1
StatePublished - 2023

All Science Journal Classification (ASJC) codes

  • Medicine(all)


Dive into the research topics of 'Atypical Guillain-Barré syndrome presenting with fluctuating weakness'. Together they form a unique fingerprint.

Cite this