Guillain-Barré Syndrome Induced Dysautonomia Resulting in Cardiac Arrest

Life-threatening cardiovascular complications can occur as a result of Guillain-Barré Syndrome (GBS) induced autonomic dysfunction necessitating the need for early recognition and potential cardiac pacing. We present the case of a 69-year-old female who was admitted to the hospital for worsening fatigue, bilateral lower extremity weakness and inability to ambulate for two days. Five days later, she experienced large fluctuations in blood pressure, appeared diaphoretic, and had spells of bradycardia. This was soon followed by an episode of unresponsive and cardiac arrest with rhythm strip consistent with asystole. Cardiopulmonary resuscitation (CPR) was initiated with a return of spontaneous circulation (ROSC) after 6 minutes. The patient was intubated and transferred to the intensive care unit (ICU). Reassessment of the patient revealed a new bilateral symmetric upper extremity weakness. Respiratory failure with ascending symmetric paralysis warranted a lumbar puncture which revealed albuminocytologic dissociation-ultimately leading to the diagnosis of GBS.