Ptosis as the initial presentation of Guillain-Barré syndrome

The Journal of Emergency Medicine
Hao-Wen Teng, Jia-Ying Sung

Abstract

Guillain-Barré syndrome has been regarded as a spectrum of diseases with many variants. To present a case in which, when the ocular muscles are affected in the beginning, it is very challenging to distinguish Guillain-Barré syndrome from myasthenia gravis. We describe a patient with Guillain-Barré syndrome who presented initially with isolated ptosis without ophthalmoplegia and subsequently developed descending paralysis. Due to the primary involvement of the lid levators, the patient was initially diagnosed as having a myasthenic crisis. Although extremely rare, Guillain-Barré syndrome can present initially as isolated ptosis with subsequent descending paralysis.

References

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Jan 10, 2001·Neurology·S J OhG C Claussen
Mar 5, 2004·The Neurologist·Kerry H Levin
Dec 6, 2006·Optometry : Journal of the American Optometric Association·Andrew S Gurwood, Jenni Drake

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Citations

Sep 1, 2015·Muscle & Nerve·Benjamin R Wakerley, Nobuhiro Yuki
Apr 16, 2013·Case Reports in Neurological Medicine·Yahia Z Imam, Dirk Deleu
Aug 23, 2017·Journal of Clinical Neuromuscular Disease·Francis B Panosyan
Apr 9, 2019·Journal of Neuroimmunology·Paul MaddisonAngela Vincent

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