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LETTER TO THE EDITOR
Year : 2015  |  Volume : 5  |  Issue : 1  |  Page : 62-63

Guillain-Barré syndrome presenting as Bell's palsy with crossed hemiparesis


Department of Medicine, Dr. Rajendra Prasad Government Medical College Kangra, Tanda, Kangra, Himachal Pradesh, India

Date of Web Publication2-Mar-2015

Correspondence Address:
Vivek Chauhan
Department of Medicine, Dr. Rajendra Prasad Government Medical College Kangra, Tanda, Kangran - 176 001, Himachal Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2229-5151.152352

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How to cite this article:
Chauhan V, Sharma G, Rana B S, Jearth V, Sandhu J. Guillain-Barré syndrome presenting as Bell's palsy with crossed hemiparesis. Int J Crit Illn Inj Sci 2015;5:62-3

How to cite this URL:
Chauhan V, Sharma G, Rana B S, Jearth V, Sandhu J. Guillain-Barré syndrome presenting as Bell's palsy with crossed hemiparesis. Int J Crit Illn Inj Sci [serial online] 2015 [cited 2019 Sep 15];5:62-3. Available from: http://www.ijciis.org/text.asp?2015/5/1/62/152352

Dear Editor,

The rare variants of Guillain - Barré syndrome (GBS) are Miller - Fisher and Bickerstaff's brainstem encephalitis, and facial diplegia. [1] GBS can very rarely present as crossed hemiparesis, which occurred in our case. A 45-year-old female presented with left-sided Bell's palsy [Figure 1]a for 1 day with right-sided hemiparesis. The reflexes were diminished bilaterally and plantars were mute. First possibility in this case was a posterior circulation stroke, but her MRI brain ruled out any infarct or hemorrhage. On 2 nd day, she developed quadriparesis with facial diplegia [Figure 1]b, dysphagia, and bulbar palsy. Now we could make a confident diagnosis of GBS and cerebrospinal fluid (CSF) examination also showed albumino-cytological dissociation (proteins 259 mg/dl and total leukocyte count of 4 cells/mm 3 ). She was treated with intravenous immunoglobulins and a month later she came back walking without support and facial diplegia was also improving [Figure 1]c and d. To conclude, GBS can very rarely present as Bell's palsy with crossed hemiparesis.
Figure 1: (a) Bell's palsy on left side at presentation. (b) Facial diplegia on 2nd day of admission. (c) Patient able to close both eyelids after 1 month. (d) Nasolabial furrow on right side at 1 month, left side is still weak

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   References Top

1.
Mori M, Kuwabara S, Fukutake T, Hattori T. Plasmapheresis and miller fisher syndrome: Analysis of 50 consecutive cases. J Neurol Neurosurg Psychiatry 2002;72:680.  Back to cited text no. 1
    


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