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Background <p>The pharyngeal–cervical–brachial (PCB) variant of Guillain–Barré syndrome (GBS) is a rare localized subtype characterized by rapidly progressive oropharyngeal, neck, and upper limb weakness with relative sparing of the lower limbs. Its rarity often leads to diagnostic delay.</p> Case Presentation <p>A 19-year-old woman presented with acute bilateral upper limb weakness, nasal speech, and dysphagia following a brief febrile illness. Examination revealed profound upper limb weakness, upper limb areflexia, bilateral facial weakness, and glossopharyngeal nerve palsy. CSF showed albumin cytological dissociation, and nerve conduction studies demonstrated reduced motor amplitudes with absent F-waves. PCB variant of GBS was diagnosed, and intravenous immunoglobulin initiated. She required mechanical ventilation and improved with immunotherapy and rehabilitation.</p> Conclusion <p>PCB variant of GBS is an uncommon but important differential diagnosis in patients presenting with acute bulbar symptoms and upper limb weakness. Awareness of this variant, careful neurological examination, and early treatment can prevent morbidity and improve outcomes.</p>

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Bilateral facial and glossopharyngeal nerve palsy in a pharyngeal cervical brachial variant of guillain–barré syndrome: a case report

  • 期刊论文

  • 发表日期：

    2026年1月5日

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  • Vignesh Jayaprakash,
  • Shibu Sasidharan,
  • Kushal Sharma

摘要

Background

The pharyngeal–cervical–brachial (PCB) variant of Guillain–Barré syndrome (GBS) is a rare localized subtype characterized by rapidly progressive oropharyngeal, neck, and upper limb weakness with relative sparing of the lower limbs. Its rarity often leads to diagnostic delay.

Case Presentation

A 19-year-old woman presented with acute bilateral upper limb weakness, nasal speech, and dysphagia following a brief febrile illness. Examination revealed profound upper limb weakness, upper limb areflexia, bilateral facial weakness, and glossopharyngeal nerve palsy. CSF showed albumin cytological dissociation, and nerve conduction studies demonstrated reduced motor amplitudes with absent F-waves. PCB variant of GBS was diagnosed, and intravenous immunoglobulin initiated. She required mechanical ventilation and improved with immunotherapy and rehabilitation.

Conclusion

PCB variant of GBS is an uncommon but important differential diagnosis in patients presenting with acute bulbar symptoms and upper limb weakness. Awareness of this variant, careful neurological examination, and early treatment can prevent morbidity and improve outcomes.