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Blindness, weakness, and tingling.

Damien Biotti1, Catherine Vignal, Tarek Sharshar

  • 1Department of Neurology, Fondation Ophtalmologique A. De Rothschild, Paris, France. dbiotti@hotmail.com

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|March 9, 2012
PubMed
Summary
This summary is machine-generated.

A rare case of Guillain-Barré syndrome (GBS) with bilateral optic neuritis occurred in a 50-year-old man. Prompt treatment improved motor function but left significant visual impairment, suggesting Mycoplasma pneumoniae as a potential cause.

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Area of Science:

  • Neurology
  • Ophthalmology
  • Infectious Diseases

Background:

  • Guillain-Barré syndrome (GBS) is an autoimmune disorder affecting the peripheral nervous system.
  • Optic neuritis, inflammation of the optic nerve, can cause vision loss.
  • Concomitant GBS and optic neuritis is a rare clinical presentation.

Observation:

  • A previously healthy 50-year-old man presented with acute bilateral vision loss, paresthesias, and rapid progression to quadriplegia, facial diplegia, bulbar palsy, and respiratory distress.
  • Clinical, lumbar puncture, and electromyography findings confirmed GBS.
  • Ophthalmological examination revealed bilateral optic neuritis, with vision deteriorating to hand motions.

Findings:

  • Despite aggressive treatment with intravenous immunoglobulin, plasmapheresis, and corticosteroids, motor deficits resolved, but visual acuity remained significantly impaired (20/100 OD, count fingers OS).
  • Extensive testing for immunological, inflammatory, infectious, and genetic causes was unremarkable.
  • The presentation suggests a possible association between GBS-associated optic neuritis and Mycoplasma pneumoniae infection.

Implications:

  • This case highlights the potential for severe visual impairment in GBS-associated optic neuritis, even with comprehensive treatment.
  • Early recognition and consideration of Mycoplasma pneumoniae infection may be crucial for managing this rare GBS variant.
  • Further research is warranted to elucidate the pathophysiology and optimize treatment strategies for GBS-associated optic neuritis.