Abdominal pain as a presenting symptom of the Guillain-Barré syndrome

Guillain-Barré syndrome (acute inflammatory polyneuropathy) is a rare disorder with an incidence of one to two per 100,000 per year (Kennedy et al., 1978) but it is the commonest cause of acute muscle weakness in patients under 40 years of age. The clinical diagnosis is made by finding a symmetrical motor and sensory peripheral neuropathy, commonly with cranial nerve involvement. Mechanical ventilation is required in 14% of patients because of paralysis of the respiratory muscles. Early treatment with plasma exchange leads to more rapid and complete recovery of neurological function, and reduces the time spent on the ventilator. Early diagnosis and referral for plasma exchange is therefore very important. The present authors report a case in which abdominal pain was the patient's initial symptom and her main complaint.