Speakers - NWC 2024

Abstract

Objective: To bring awareness to Pure-Sensory Guillain-Barre Syndrome (GBS), a rare variant of GBS with fewer than 50 cases reported in literature.

Methods: Our patient was seen by the authors in the hospital. History, neurologic exam, and laboratory testing were used to systematically work up a thorough differential.

Results: We report a 42-year-old woman who presented to the hospital with gait instability. Two weeks prior, she experienced diarrhea. Two days before presentation, she began to feel diffuse body aches, difficulty walking, and numbness in her hands and feet. One day later, she experienced issues with hand coordination. On admission, the neurologic exam was significant for a positive Romberg sign and areflexia in the patellar and Achilles reflexes bilaterally. A gastrointestinal PCR pathogen panel was positive for Campylobacter. The patient had normal levels of vitamin B1, B9 and B12. MRI of the full spine was unremarkable. Lumbar puncture was positive for GQ1b antibodies. The patient was treated with IVIG over five days and fully recovered within eight weeks.

Discussion: We present a case of GBS that affected only sensory modalities in an ascending pattern. This represents a rare and potentially underreported variant of GBS:, pure-sensory GBS. Previous studies have shown the presence of GQ1b antibodies in patients with recent C. jejuni infection and sensory deficits with sparing of motor nerves. It is unclear how the presence of GQ1b antibodies relates to the pure-sensory presentation. Currently, there is a gap in the literature on the relationship between GQ1b antibodies and pure-sensory GBS. Other GQ1b associated forms of GBS (Miller-Fisher Syndrome, pharyngeal-cervical-brachial GBS, and Bickerstaff brainstem encephalitis) exist. However, these are not motor sparing. Additionally, GQ1b antibodies have not been present in all cases of pure-sensory GBS. We believe that pure-sensory GBS should be considered in patients with ascending sensory deficits.