Paradoxical Hyperreflexia in a Patient With Classic Guillain-Barré Syndrome

Area of Science:

• Neurology
• Immunology

Background:

• Guillain-Barré syndrome (GBS) is a rare autoimmune disorder.
• It typically presents with ascending paralysis and areflexia.
• Psychiatric comorbidities can complicate GBS diagnosis.

Observation:

• A young female with bipolar disorder presented with acute bilateral lower leg weakness.
• She exhibited paradoxical hyperreflexia and normal cerebrospinal fluid (CSF) protein levels.
• Symptoms began approximately one month after bloody diarrhea.

Findings:

• Electromyography (EMG) and nerve conduction studies (NCS) confirmed an axonal and demyelinating neuropathy.
• The patient was diagnosed with classic Guillain-Barré syndrome.
• The presentation included paradoxical hyperreflexia, an atypical GBS feature.

Implications:

• This case underscores the importance of considering GBS in patients with atypical neurological presentations.
• Recognizing paradoxical hyperreflexia is crucial for accurate GBS diagnosis.
• Understanding GBS in the context of psychiatric comorbidities aids in comprehensive patient care.