Critical illness polyneuropathy or axonal Guillain–Barré syndrome triggered by subarachnoid haemorrhage?
(2013) OA Case Reports — Vol. 2, n° 9, p. 86 [1-2] (2013)
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- INTRODUCTION: This article reports a case of the difficulty to differentiate between critical illness polyneuropathy and axonal Guillain–Barré syndrome when triggered by subarachnoid haemorrhage. CASE REPORT: An 81-year-old man was admitted comatose (Glasgow coma scale score 4/15) after a subarachnoid haemorrhage. His neurological condition gradually improved with as best motor response (M4) withdrawal from pain at the four limbs. The patient developed early complications such as septicaemia and acute renal injury. After 3 weeks, a marked decrease of motor response (M1) was noted in the lower, and, to lesser extent, upper limbs. Deep tendon reflexes were abolished. The cerebrospinal fluid examination showed elevated protein level. After electrophysiological examination, the diagnosis of acute motor axonal neuropathy, a variant of Guillain–Barré syndrome, was discussed versus critical illness polyneuropathy. Specific therapy for Guillain–Barré syndrome could not be administered. No significant motor recovery was observed after 7 months. CONCLUSION: The distinction between critical illness polyneuropathy and Guillain–Barré syndrome remains difficult in critically ill patients. It is not known if subarachnoid haemorrhage could be considered as a possible triggering factor for Guillain–Barré syndrome.
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Hantson, P., Wittebole, X., & Van den Bergh, P. (2013). Critical illness polyneuropathy or axonal Guillain–Barré syndrome triggered by subarachnoid haemorrhage? OA Case Reports, 2(9), 86 [1-2]. https://hdl.handle.net/2078.5/48188 (Original work published 2013)