title: Ptosis as the initial presentation of Guillain-Barré syndrome.
abstract: 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.
authors.affiliation: Department of Neurology, Taipei Medical University - Wan Fang Hospital, Taipei, Taiwan.
authors.forename: Hao-Wen
authors.initials: HW
authors.lastname: Teng
authors.forename: Jia-Ying
authors.initials: JY
authors.lastname: Sung
mesh_terms: 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