Fulminant Guillain Barre Syndrome AMSAN Variant Mimicking Brain Death: A Lesson in Persistence

Simple item page
dc.contributor.authorSomaraj, Men_US
dc.contributor.authorNegi, Aen_US
dc.contributor.authorGopi, Ren_US
dc.contributor.authorStanley, W.en_US
dc.date.accessioned2024-11-30T08:52:07Z
dc.date.available2024-11-30T08:52:07Z
dc.date.issued2024-08
dc.description.abstractGuillain-Barre syndrome (GBS) is the most common cause of acute flaccid paralysis. It commonly presents as acute symmetric ascending lower motor neuron palsy which typically occurs about one to three weeks following either a gastrointestinal or upper respiratory tract infection. GBS is termed fulminant when associated with rapid deterioration with flaccid quadriparesis, absent brainstem reflexes, and ventilator requirement. Here, we report a case of a female in her twenties who presented with a history of weakness and sensory loss a few days after recovering from a diarrheal illness. She developed progressive ascending paralysis of her muscles within 24 hours and was intubated anticipating respiratory failure. Initial examination revealed dilated pupils and the presence of ocular movements, as well as bilateral facial nerve involvement. Investigative findings were consistent with GBS and intravenous immunoglobulin (IVIg) treatment was promptly initiated. Despite this, the patient deteriorated further and lost brainstem reflexes and failed to demonstrate spontaneous breaths. EEG indicated a deep coma. We continued with supportive care and physiotherapy and, after approximately 10 days of no initial response, our patient remarkably regained muscle power and sensations. She was eventually weaned off ventilation and has since returned to full functional status. This case report highlights the importance of persistence in treatment despite atypical presentations and initial clinical deterioration. Further, this case of fulminant GBS, AMSAN variant, involving the short ciliary nerve and mimicking brain death is a rare entity in clinical literature.en_US
dc.identifier.affiliationsDepartment of Medicine, Kasturba Medical College, Manipal, Karnataka, Indiaen_US
dc.identifier.affiliationsDepartment of Medicine, Kasturba Medical College, Manipal, Karnataka, Indiaen_US
dc.identifier.affiliationsDepartment of Medicine, Kasturba Medical College, Manipal, Karnataka, Indiaen_US
dc.identifier.affiliationsDepartment of Medicine, Kasturba Medical College, Manipal, Karnataka, Indiaen_US
dc.identifier.citationSomaraj M, Negi A, Gopi R, Stanley W.. Fulminant Guillain Barre Syndrome AMSAN Variant Mimicking Brain Death: A Lesson in Persistence. Journal of Advances in Medicine and Medical Research. 2024 Aug; 36(9): 56-62en_US
dc.identifier.issn2456-8899
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/237249
dc.languageenen_US
dc.publisherMs. M. B. Mondalen_US
dc.relation.issuenumber9en_US
dc.relation.volume36en_US
dc.source.urihttps://doi.org/10.9734/jammr/2024/v36i95557en_US
dc.subjectGuillain-barreen_US
dc.subjectfulminanten_US
dc.subjectbrain-deathen_US
dc.subjectAMSANen_US
dc.subjectposterior ciliary nerveen_US
dc.titleFulminant Guillain Barre Syndrome AMSAN Variant Mimicking Brain Death: A Lesson in Persistenceen_US
dc.typeJournal Articleen_US
Files
Original bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
jammr2024v36n9p56.pdf
Size:
367.08 KB
Format:
Adobe Portable Document Format
Download
Collections
Journal of Advances in Medicine and Medical Research