Guillain-Barre Syndrome With Concomitant Severe Preeclampsia: A Case Report

Area of Science:

• Neurology
• Obstetrics
• Critical Care Medicine

Background:

• Guillain-Barre syndrome (GBS) is a rare autoimmune disorder causing flaccid paralysis, with approximately 100,000 new cases annually worldwide.
• Pregnancy is a rare demographic for GBS, posing significant risks to both maternal and fetal health.
• Concurrent conditions like gestational hypertension and preeclampsia can complicate the diagnosis and management of GBS during pregnancy.

Observation:

• A 38-year-old primigravida at 38 weeks six days gestation presented with ascending paraplegia, dysarthria, dysphagia, and facial weakness.
• Initial diagnosis at an outside institution was clinical Guillain-Barre syndrome, supported by elevated cerebrospinal fluid protein.
• The patient also developed preeclampsia with severe features, indicated by a sudden rise in liver function tests.

Findings:

• The patient underwent a cesarean delivery, after which respiratory failure prevented extubation.
• Following a 20-day intensive care unit stay, the patient was successfully extubated.
• Neurologic status showed improvement, returning close to her baseline.

Implications:

• This case underscores the complex interplay between Guillain-Barre syndrome and preeclampsia in late pregnancy.
• Effective management requires a multidisciplinary approach involving neurology, obstetrics, and critical care.
• Prompt diagnosis and supportive care are crucial for optimizing outcomes in pregnant patients with GBS.