Posterior reversible encephalopathy as the initial manifestation of a Guillain-Barré syndrome.
We report a female patient with posterior reversible encephalopathy syndrome as the initial manifestation of a Guillain-Barré syndrome. She presented with headache and paraesthesias of the fingertips three days after gastroenteritis. Examination revealed hypertension and tachypnoea. Brain MRI showed a bi-occipital vasogenic edema consistent with the syndrome. Subsequent examination showed a tetraparesis. Cerebrospinal fluid analyses revealed albuminocytologic dissociation and the diagnosis of Guillain-Barré syndrome was made. The typical radiological and clinical features of posterior reversible encephalopathy syndrome (headache and hypertension) were present prior to the clinical manifestation of Guillain-Barré syndrome. We suggest posterior reversible encephalopathy syndrome to be considered as an initial manifestation of Guillain-Barré syndrome.
Sutter
R
R
Department of Neurology, University of Basel, Petersgraben 4, Basel 4031, Switzerland. sutterR@uhbs.ch
Mengiardi
B
B
Lyrer
P
P
Czaplinski
A
A
D001921:Brain / Q000473:pathology; D001927:Brain Diseases / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000473:pathology*; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D020275:Guillain-Barre Syndrome / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000473:pathology*; D006261:Headache / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D006973:Hypertension / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008875:Middle Aged