A report of a probable case of familial Guillain Barre syndrome
A 26- year old woman with an upper respiratory tract infection 2 weeks prior to admission who developed progressive weakness in the upper and lower limbs 3 days before admission is reported. On admission, she had generalized weakness and paresthesia with mild bilateral peripheral facial nerve palsy and no respiratory distress or sphincter involvement. No deep tendon reflexes were detected, plantar reflex was absent on both sides while muscle forces were more diminished in the lower limbs (4/5 versus 3/5 MRC). In 3 days, her diminishing muscle forces from 4/5 to 3/5 MRC in the upper limbs and from 3/5 to 2/5 MRC in the lower limbs confined her to bed. She underwent plasmaphresis and received IVIG due to persistent weakness despite no need for mechanical ventilation.\nMotor nerve conduction velocities were slowed in the upper and lower limbs. Action potential amplitudes were reduced more in the lower limbs (right ulnar 0.6 mV; right tibialis 0.4 mV). Distal motor latencies were prolonged (right median 5 ms; right distal tibialis 10.6 ms). The right median F wave latency was increased at 36.6 ms and the left distal tibialis and proneal F waves were absent. Sensory nerve conduction velocities and action potential amplitudes were normal. Cerebrospinal fluid (CSF) analysis on the same day showed 140 mgr/dL protein and 93 mgr/dL glucose concentrations with cytoprotein dissociatin, all interpreted as acute inflammatory demyelinating polyradiculoneuropathy (AIDP) considering clinical course. She was discharged on Day 17 and she fully recovered in 3 months.