Pharyngeal-cervical-brachial variant of Landry Guillain Barre syndrome after dengue infection: a case report

Authors

  • Vineet Sehgal Department of Neurology, Amandeep Medicity, Amritsar, Punjab, India
  • Lucky Bhalla Department of Peadiatrics, Sehgal Neuro and Child Care Centre, Amritsar, Punjab, India
  • Priyanshu Bansal Departmnet of Neurology, Sehgal Neuro and Child Care Centre, Amritsar, Punjab, India http://orcid.org/0000-0002-4827-6167
  • Shaifali Arora Departmnet of Neurology, Sehgal Neuro and Child Care Centre, Amritsar, Punjab, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20214878

Keywords:

Pharyngeal cervical brachial variant, Landry Guillain Barre syndrome, Dengue, Cephalocaudal weakness, Oropharyngeal weakness

Abstract

Dengue is a common mosquito-borne infection in India. We reported a rare Pharyngeal cervical brachial (PCB) variant of Landry Guillain Barre syndrome (LGBS) associated with the dengue virus infection. The pathogenesis seems to be molecular mimicry between gangliosides and microbial lipo-oligosaccharides. PCB usually presents with oropharyngeal or cervicobrachial weakness. Therefore, it must be recognised early and distinguished from conditions presenting with cephalocaudal progressing weakness, such as Myasthenia Gravis, Miller-Fisher syndrome, botulism, diphtheria, porphyria or brain stem stroke. The aim of the study was to add to the limited literature on the PCB variant of LGBS after dengue infection and shed some light on presentation and management options for this rare entity.

Author Biography

Vineet Sehgal, Department of Neurology, Amandeep Medicity, Amritsar, Punjab, India

Medical Officer, Department of Neurology

References

WHO. Dengue guidelines, for diagnosis, treatment, prevention and control, 2021. Available at: https://www.who.int/publications/i/item/9789241547871. Accessed on 08 December 2021.

Artal FJC, Wichmann O, Farrar F, Gascón J. Neurological complications of dengue virus infection. Lancet Neurol. 2013;12(9):906-16.

Li GH, Ning ZJ, Liu YM, Li XH. Neurological Manifestations of Dengue Infection. Front Cell Infect Microbiol. 2017;7:449.

Ropper AH. Unusual clinical variants and signs in Guillain-Barré syndrome. Arch Neurol. 1986;43(11):1150-2.

Wakerley BR, Yuki N. Pharyngeal-cervical-brachial variant of Guillain-Barre syndrome. J Neurol Neurosurg Psychiatry. 2014;85(3):339-44.

Mohiuddin O, Khan AA, Waqar SHB, Shaikh AT, Marufi MM, Jalees S, et al. Pharyngeal-cervical-brachial variant of Guillain-Barré syndrome: a case report of a rare complication following Dengue-Chikungunya co-infection. Pan Afr Med J. 2021;38:356.

Randhawa J, Randhawa HS, Toor P. Pharyngeal-Cervical-Brachial Variant of Guillain-Barré Syndrome in a Patient of COVID-19 Infection. Cureus. 2021;13(9):17945.

Nissan A, Hernández JC, Sorsby A, Zermeño M, Calzada A. Pharyngeal-Cervical-Brachial Variant of Guillain-Barré Syndrome. Cureus. 2021;13(10):18788.

Nagashima T, Koga M, Odaka M, Hirata K, Yuki N. Continuous spectrum of pharyngeal-cervical-brachial variant of Guillain-Barré syndrome. Arch Neurol. 2007;64(10):1519-23.

Hughes RAC, Cornblath DR, Willison HJ. Guillain-Barré syndrome in the 100 years since its description by Guillain, Barré and Strohl. Brain. 2016;139(11):3041-7.

Downloads

Published

2021-12-23

Issue

Section

Case Reports