42PRare case of Guillain-Barré syndrome presenting as isolated acute dysphagia with full recovery

Abstract

Guillain-Barré syndrome (GBS) is an acute immune-mediated polyneuropathy, typically presenting with progressive limb paralysis. Dysphagia can occur due to cranial nerve involvement. We report the case of a 76-year-old woman who developed sudden-onset dysphagia and was subsequently diagnosed with an atypical GBS variant. Notably, she exhibited no limb weakness or sensory abnormalities but required nasogastric tube feeding due to severe swallowing difficulty. Electromyography and nerve conduction studies showed no evidence of polyneuropathy suggestive of GBS, while cerebrospinal fluid analysis revealed mild albumin-cytological dissociation. Following intravenous immunoglobulin therapy, she achieved complete recovery. This case highlights that, in rare GBS variants, dysphagia may be the initial or sole manifestation, posing diagnostic challenges. It underscores the importance of a thorough evaluation of swallowing mechanisms and vigilance in identifying uncommon etiologies.