Asymmetric limb weakness in Guillain-Barré syndrome: Three case reports

Area of Science:

• Neurology
• Immunology
• Peripheral Nervous System Disorders

Background:

• Guillain-Barré syndrome (GBS) is an autoimmune neuropathy typically causing symmetric weakness.
• Asymmetric GBS is an uncommon presentation that can mimic other neurological conditions.
• This study focuses on the rare subtype of GBS with asymmetric limb weakness.

Observation:

• Three patients presented with persistent asymmetric limb weakness from onset to recovery.
• All patients had serological evidence of antecedent infections.
• Two patients tested positive for IgG antibodies against ganglioside GM1.

Findings:

• Patients received immunotherapy (IVIg, plasma exchange) or supportive care.
• Potential contributing factors include anti-ganglioside antibodies, blood-nerve barrier asymmetry, and limb use.
• Asymmetric GBS is a rare clinical variant of GBS.

Implications:

• Clinicians should consider asymmetric GBS in cases of acute, progressive asymmetric limb weakness.
• Further large-scale studies are needed to investigate differences in clinical features and prognosis compared to classic GBS.