Guillain–Barré syndrome with positive anti-sulfatide antibodies (Paraplegia with bilateral facial nerve palsy): A case report and retrospective analysis

Guillain–Barré syndrome (GBS) is an autoimmune inflammatory neuropathy frequently triggered by infections such as the Epstein–Barr virus and influenza B virus. While cranial nerve involvement occurs in nearly half of the cases, atypical presentations, including paraplegia with bilateral facial nerve palsy, are extremely rare. Herein, we report a 42-year-old female presenting with progressive lumbosacral pain, paraplegia, and bilateral facial nerve palsy. Diagnostic findings included demyelinating changes on electromyography, protein-cell separation in cerebrospinal fluid, and elevated anti-sulfatide immunoglobulin (Ig)G antibodies, confirming acute inflammatory demyelinating polyneuropathy. Treatment with intravenous Ig and adjunct therapies resulted in significant recovery and improved quality of life. This case emphasizes the diagnostic role of anti-sulfatide antibody testing in atypical GBS and highlights the potential of sulfatide-targeted therapies as novel interventions.