title: An unusual case of recurrent guillain-barre syndrome of a different subtype five years after initial diagnosis.
abstract: We present a case of a previously healthy 17-year-old girl with history of Guillain-Barre Syndrome 5 years after initial presentation who presented with bilateral lower extremity pain, worsening dysphagia, subsequent weakness, and decreased reflexes. Cerebrospinal fluid analysis had a prominent lymphocytic pleocytosis. MRI of spine showed significant anterior nerve root enhancement. Electromyogram demonstrated a mild axonal greater than demyelinating motor polyneuropathy and intact sensory responses, with no evidence of conduction block or temporal dispersion, unlike her first presentation that revealed a demyelinating polyneuropathy. The patient recovered with mild subjective weakness following 5 days of intravenous immunoglobulin treatment. This case represents a recurrence of a predominantly motor variant polyradiculoneuropathy distinct from the initial presentation with a lymphocytic predominant CSF pleocytosis, nerve root enhancement on MRI spine, and rapid recovery following treatment with intravenous immunoglobulin.
authors.affiliation: Department of Pediatrics, University of California, San Diego and Rady Children's Hospital, USA.
authors.forename: M
authors.initials: M
authors.lastname: Dy
authors.forename: R L
authors.initials: RL
authors.lastname: Leshner
authors.forename: J R
authors.initials: JR
authors.lastname: Crawford