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Background <p>Guillain–Barré syndrome (GBS) is an acute, immune-mediated polyneuropathy often triggered by preceding infections. It typically presents with ascending weakness, but variants such as Miller Fisher Syndrome (MFS) manifest with descending paralysis, ophthalmoplegia, and ataxia. Viral infections, including respiratory pathogens and COVID-19, are known triggers for GBS, but relapses associated with successive infections are rare. Our case demonstrates a rare presentation of relapsing GBS with ophthalmoplegia as the main presenting symptom.</p> Case presentation <p>We present a 46-year-old Middle Eastern man with no chronic illnesses who experienced recurrent episodes of Guillain–Barré Syndrome (GBS) triggered by viral infections, presenting in an unusual form. In 2017, he developed acute dysphagia, diplopia, and limb weakness following an upper respiratory tract infection, diagnosed as Miller Fisher variant GBS and treated successfully with IVIg. In 2022, after COVID-19 infection and ICU admission, he experienced a relapse with similar symptoms and responded well to IVIg. In 2024, he presented again with dysphagia, diplopia, and facial weakness with minimal limb involvement following an Influenza A infection. Despite initial deterioration requiring NGT insertion, gradual improvement occurred after 5 days of IVIg treatment. Nerve conduction studies confirmed demyelinating neuropathy.</p> Conclusion <p>This case highlights the association between viral infections and recurrent GBS, presenting with descending weakness—an uncommon feature—emphasizing the importance of early recognition and management, even when clinical presentations deviate from typical patterns.</p>

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A patient of relapsing Guillain–Barré syndrome with unusual ocular presentation: a case report

  • 期刊论文

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  • 发表日期：

    2025年9月19日

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  • Ahmed Dahshan,
  • Ahmed Hamdy Youssef,
  • Alaa Ahmed Shalan,
  • Emad Salah Fathy Saleh,
  • Hassan Afif Hassan Mohammed,
  • Robina Gonzales,
  • Brighty Merin Daniel

摘要

Background

Guillain–Barré syndrome (GBS) is an acute, immune-mediated polyneuropathy often triggered by preceding infections. It typically presents with ascending weakness, but variants such as Miller Fisher Syndrome (MFS) manifest with descending paralysis, ophthalmoplegia, and ataxia. Viral infections, including respiratory pathogens and COVID-19, are known triggers for GBS, but relapses associated with successive infections are rare. Our case demonstrates a rare presentation of relapsing GBS with ophthalmoplegia as the main presenting symptom.

Case presentation

We present a 46-year-old Middle Eastern man with no chronic illnesses who experienced recurrent episodes of Guillain–Barré Syndrome (GBS) triggered by viral infections, presenting in an unusual form. In 2017, he developed acute dysphagia, diplopia, and limb weakness following an upper respiratory tract infection, diagnosed as Miller Fisher variant GBS and treated successfully with IVIg. In 2022, after COVID-19 infection and ICU admission, he experienced a relapse with similar symptoms and responded well to IVIg. In 2024, he presented again with dysphagia, diplopia, and facial weakness with minimal limb involvement following an Influenza A infection. Despite initial deterioration requiring NGT insertion, gradual improvement occurred after 5 days of IVIg treatment. Nerve conduction studies confirmed demyelinating neuropathy.

Conclusion

This case highlights the association between viral infections and recurrent GBS, presenting with descending weakness—an uncommon feature—emphasizing the importance of early recognition and management, even when clinical presentations deviate from typical patterns.