Very rare. Localized variant of the Guillain-Barre syndrome (see this term) affecting especially the oropharynx, neck and upper limbs. There are no ataxia nor disorders of consciousness. The differential diagnosis includes myasthenia gravis, botulism, a brainstem tumor and a cerebrovascular accident.

Clinical picture:

-        acute dysphonia, dysarthia

-        swallowing disorders

-        involvement of the cranial nerves: mydriasis, ptosis

-        moderate impairment of the limbs is sometimes present

Sometimes, a recent history of Campylobacter jejuni infection is noted.

Brain MRI is normal and the results of blood and CSF tests and EMG are variable. Often anti-GT1a, or more raely anti-GQ1b antibodies can be found

The prognosis is good after treatment with IV immunoglobulins .

Anesthetic implications:

acute phase: swallowing disorders, ineffective cough.

References:

-         Lametery E, Dubois-Teklali F, Millet A, Manel V.
Le syndrome pharyngo-cervico-brachial: un tableau de syndrome de Guillain-Barré atypique avec paralysie bulbaire sévère.
Arch Pédiatr 2016 ; 23 :176-9.

Updated: October 2018