Unilateral cranial and phrenic nerve involvement in axonal Guillain-Barré syndrome

A 49-year-old woman developed acute left facial, hypoglossal, and phrenic nerve palsies, as well as dysphagia and weakness in the neck and arms. Electrophysiologic studies showed an acute motor axonal neuropathy. Serum anti-GM1 IgG antibody was positive. Intravenous immunoglobulin treatment resulted in good clinical recovery. The present report indicates that the cranial and phrenic nerves may be affected unilaterally in Guillain-Barré syndrome, and that there is clinical variability in the axonal subtype of this syndrome.