Ptosis as the initial presentation of Guillain-Barré syndrome.
BACKGROUND
Guillain-Barré syndrome has been regarded as a spectrum of diseases with many variants.


OBJECTIVE
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.


METHODS
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.


CONCLUSIONS
Although extremely rare, Guillain-Barré syndrome can present initially as isolated ptosis with subsequent descending paralysis.
Teng
Hao-Wen
HW
Department of Neurology, Taipei Medical University - Wan Fang Hospital, Taipei, Taiwan.
Sung
Jia-Ying
JY
D000328:Adult; D001763:Blepharoptosis / Q000209:etiology*; D005260:Female; D020275:Guillain-Barre Syndrome / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D009157:Myasthenia Gravis / Q000175:diagnosis; D010243:Paralysis / Q000209:etiology; D010956:Plasmapheresis; D016896:Treatment Outcome