Rehabilitation challenges and progress in a patient with sensory ataxic Guillain-Barré syndrome: a case report

The sensory ataxia variant of Guillain - Barré syndrome (GBS) is a rare form with an unconfirmed prognosis and clinical course and no documented rehabilitation outcomes.

This report describes the clinical course - from onset to discharge - and the rehabilitation details of a patient with sensory ataxic GBS who struggled to regain independent ambulation 6 months after intravenous immunoglobulin (IVIg) therapy.

A 75-year-old male was admitted with abnormal sensations and severe limb and trunk ataxia. Owing to the severity of ataxia, the patient was fully dependent on assistance with activities of daily living (ADLs). Muscle strength was mildly weakened in the right hand but was otherwise normal. Cerebrospinal fluid analysis revealed albuminocytologic dissociation, and nerve conduction studies showed poor sensory response conduction.

Physical therapy focused on standing and gait training, whereas occupational therapy targeted balance and ADL training. Because sensory recovery was slow, the intervention aimed to maintain muscle strength and joint range of motion, providing maximal assistance during standing and gait activities; the level of assistance was modified according to the patient's response.

The patient was transferred to a rehabilitation hospital 33 days after IVIg administration and was discharged 21 weeks later. At that time, the patient could transfer to a wheelchair and move around independently using the wheelchair; additionally, walking was possible with a walker under supervision but independent walking was not possible. The Scale for the Assessment and Rating of Ataxia score improved from 31 to 20.

In cases of sensory ataxic GBS with severe ataxia, prevention of functional decline during the acute phase until the observation of reduced ataxia symptoms is critical. The rehabilitation and treatment course described in this case may provide valuable insights for managing patients with sensory ataxic GBS who experience difficulty with recovery.