Giant negative T waves in Guillain-Barré syndrome

Area of Science:

• Cardiology
• Neurology
• Medical Imaging

Background:

• Guillain-Barré syndrome is an autoimmune disorder affecting the peripheral nervous system.
• Cardiac complications in Guillain-Barré syndrome are rare but can be severe.

Observation:

• A patient with Guillain-Barré syndrome presented with significant electrocardiographic abnormalities (giant negative T waves).
• Echocardiography revealed left ventricular hypokinesis, and myocardial scintigraphy showed extensive defects.
• These cardiac abnormalities occurred at the peak of the neurological disease.

Findings:

• Treatment with gamma-globulin led to the resolution of neurological symptoms.
• Concurrently, the observed cardiac abnormalities, including T wave changes and myocardial dysfunction, also resolved.
• 123I-meta-iodobenzylguanidine scintigraphy indicated transient damage to cardiac sympathetic nerve endings.

Implications:

• The findings suggest a potential mechanism of myocardial injury in Guillain-Barré syndrome via norepinephrine toxicity affecting cardiac sympathetic nerves.
• This case highlights the importance of cardiac monitoring in Guillain-Barré syndrome patients.
• Transient cardiac sympathetic nerve damage may be reversible with appropriate treatment.