Acute bilateral vision deficit as the initial symptom in Guillain-Barre syndrome: A case report

Guillain-Barre syndrome (GBS) is a rare autoimmune-mediated peripheral neuropathy with an acute onset. GBS is associated with posterior cranial nerve injury including the facial, oculomotor, glossopharyngeal and vagus nerves. A 43-year-old female presented with worsening blurred binocular vision accompanied by diplopia, bilateral ptosis, speech difficulties, dysphagia, extremity numbness and weakness of the limbs. A neurological examination was conducted along with magnetic resonance imaging of the brain and spinal cord, electromyography, cerebrospinal fluid analysis and visual evoked potential tests, which led to a diagnosis of GBS. Following immunoglobulin administration, the patient's neurological deficiencies were markedly relieved and they were discharged following a 3-week observation period. To the best of our knowledge, this is the first reported case of GBS associated with cranial nerve damage presenting with bilateral visual deterioration as the initial symptom. It is necessary to emphasize that early diagnosis and commencing the immunological treatment in a timely manner resulted in a favorable prognosis for the patient.