Abstract

Guillain-Barre ́ syndrome (GBS) is an immune mediated neuropathological condition manifesting an acute onset
and monophasic behaviour. This neuro-muscular morbidity is often triggered by an antecedent infection either
by bacteria or virus. Although, pathology tests such as cerebrospinal fluid analysis and electrodiagnostic testing
are often indicative of the condition, medical history and examination of the symptoms is critical for primary
clinical diagnosis. A case report of a 45 years old female patient with confirmed GBS has been discussed here.
The patient presented with generalized body-ache, numbness and giddiness which was followed by nausea and
low-grade fever with anorexia for a period of two weeks. Initial test results revealed higher levels of serum
bilirubin (6.1 mg/dl) and transaminitis (SGOT/SGPT 1877/3058) which indicated at acute hepatitis, although
without any features of hepatic decompensation. Due to rapidly progressing ascending flaccid paralysis, areflexic
quadriparesis, and bifacial weakness, the diagnosis of GBS was considered. On the basis of the evidence from
nerve conduction studies along with elevated cerebrospinal fluid (CSF) protein level, diagnosis of GBS was
confirmed. Administration of intravenous immunoglobulins and plasma exchange are effective treatments
besides supportive care throughout hospitalization, which is also crucial.
Keywords: Cerebrospinal fluid, Guillain-Barre ́ syndrome, Hepatitis A, Nerve conduction studies