Guillain-Barré syndrome variant: presenting with myalgias and acute facial diplegia

A patient with no significant medical history presented with myalgias, lower extremity weakness, and facial diplegia. Upon review of systems, the patient denied any other problems. Physical examination results were remarkable for weakness in the right leg and bilateral facial diplegia. Radiological and laboratory studies were unremarkable. Lumbar puncture revealed albuminocytological dissociation. The combined history, physical examination, and lumbar puncture results established a presumptive diagnosis of Guillain-Barré syndrome. The patient began a 5-day course of intravenous immunoglobulin therapy. At the end of the 5-day course, the patient had recovered 85% of her facial muscle function and experienced complete relief of her myalgias. Upon discharge, the patient was referred to physical therapy for improvement of her facial muscle impairment.