Multiple cranial neuropathies without limb involvements: guillain-barre syndrome variant?

Area of Science:

• Neurology
• Immunology
• Rare Diseases

Background:

• Acute multiple cranial neuropathies are immune-mediated disorders, often linked to infectious, inflammatory, or systemic diseases.
• These neuropathies are considered a variant of Guillain-Barre syndrome (GBS), typically presenting with facial palsy, bulbar dysfunction, and limb weakness.
• Electrophysiological findings in reported cases are consistent with typical GBS.

Purpose of the Study:

• To describe a rare case of acute multiple cranial neuropathies presenting without limb weakness.
• To investigate the association between a benign infectious disease and a variant of GBS.
• To analyze the clinical and laboratory findings, including anti-GQ1b IgG antibody status.

Main Methods:

• Case report of a 48-year-old male patient.
• Clinical assessment of cranial nerve involvement (III-XII).
• Laboratory analysis for anti-GQ1b IgG antibody.

Main Results:

• The patient developed widespread cranial neuropathy (nerves III-XII) without limb weakness or ataxia.
• Laboratory findings revealed a positive anti-GQ1b IgG antibody.
• The presentation differed from previously described GBS variants due to the absence of limb involvement.

Conclusions:

• This case expands the spectrum of GBS variants, demonstrating that acute multiple cranial neuropathies can occur without limb weakness.
• The presence of anti-GQ1b IgG antibody supports an immune-mediated mechanism in this variant.
• Highlights the importance of considering GBS variants in patients with isolated cranial neuropathies following infections.