Atypical Presentation of Guillain-Barre Syndrome

Introduction: Guillain-Barre Syndrome (GBS) is an antibody-driven post-infective autoimmune disorder that typically presents with symmetrical ascending weakness. Other than the classical GBS, there are well-known GBS variants that have characteristic features. Here we present a case with an atypical presentation, where acute weakness and areflexia started from the right upper limb, descended to the lower limbs, and finally involved the left upper limb Case Presentation: A 42-year-old previously healthy male patient presented with acute onset right upper limb weakness that rapidly progressed in a descending manner to the lower limb and later to the left upper limb over several days. Later in the progression, respiration was also partially involved. However, other functions such as swallowing, eye movements cerebellar functions, and sensory functions were intact. MRI brain and other basic investigations were normal. MRI brain and cervical spine were normal, and nerve conduction studies showed acute motor axonal neuropathy type GBS. The patient completely recovered with IV Immunoglobulin treatment and physiotherapy without residual motor deficit.Conclusion: GBS is a heterogeneous disease with various presentations, and many rare presentations remain unstudied. Therefore, it is important to suspect GBS in any type of flaccid progressive paralysis unless proven otherwise, especially in resource-poor settings. Early detection and treatment prevent long-term motor deficits and other complications.