Posterior reversible encephalopathy syndrome as a revealing manifestation of Guillain-Barré syndrome.
We report a patient with a Guillain-Barré syndrome (GBS) revealed by a posterior reversible encephalopathy syndrome (PRES). The PRES is typically associated with bilateral parieto-occipital T2 and FLAIR hyperintense MRI lesions and observed in various etiologic conditions leading to acute arterial hypertension. PRES results from a breakdown of the circulatory autoregulation, many in the posterior cerebral territories. GBS can be considered as an independent risk factor of PRES, due to acute dysautonomia and pain with consecutive arterial hypertension, as well as to cytokine production changing capillary permability. Such patients with PRES-revealed GBS may be treated with intravenous immunoglobulin therapy only after exclusion of any ischemic or hemorrhagic cerebral complications, and after control of the blood pressure and of the encephalopathic signs and symptoms.
Department of Neurology, Clinique Sainte-Élisabeth, 206, avenue de Fré, 1180 Uccle, Brussels, Belgium.
A
A
Etxeberria
S
S
Lonneville
M-P
MP
Rutgers
M
M
Gille
D000368:Aged; D003221:Confusion / Q000209:etiology; D004576:Electromyography; D005260:Female; D005732:Gangliosides / Q000276:immunology; D020275:Guillain-Barre Syndrome / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D009460:Neurologic Examination; D009778:Occipital Lobe / Q000473:pathology; D010146:Pain / Q000209:etiology; D010296:Parietal Lobe / Q000473:pathology; D054038:Posterior Leukoencephalopathy Syndrome / Q000209:etiology* / Q000473:pathology; D054969:Primary Dysautonomias / Q000209:etiology
D005732:Gangliosides; D016756:Immunoglobulins, Intravenous; C039129:GQ1b ganglioside