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POC13 Guillain–Barre syndrome following aneurysmal subarachnoid haemorrhage: first case report
  1. V Apok,
  2. K Ghosh,
  3. P Gunawardena,
  4. N Gurusinghe
  1. Royal Preston Hospital, Preston, UK
  1. Correspondence to vinoapok{at}doctors.org.uk

Abstract

We report a rare case of Guillain–Barre syndrome (GBS) in a female patient with isolated facial diplegia following a subarachnoid haemorrhage. Her initial presentation was with a postcoital headache. Following investigation of her subarachnoid haemorrhage and subsequent embolisation, she made a good recovery. A week later, she developed bilateral lower motor neurone paralysis of the facial nerves. Her facial diplegia spontaneously resolved over a 2-month period with conservative management. The neurological signs that developed postembolisation in this patient were attributed to GBS (based on clinical presentation and electrophysiological findings). Isolated facial diplegia with little or no limb weakness has been characterised as a rare variant of the syndrome. Intracranial pathology associated with GBS has only been reported in four previous cases—all of which were traumatic. This is the first nontraumatic intracranial pathological case that has developed GBS as a temporal complication. The role of myelin basic protein as a neuro-immunogenic modulator of a demyelinating pathological process is discussed as a possible hypothesis to explain the clinical picture.

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