BACKGROUND: To describe a patient with Guillane-Barré syndrome (GBS), posterior reversible encephalopathy syndrome (PRES) and takotsubo cardiomyopathy, and in doing so, to postulate a new mechanism for hypotension in the setting of dysautonomia in GBS. METHODS: Case report. RESULTS: We report an 82-year-old woman who presented with bilateral lower extremity weakness and back pain following an upper respiratory viral illness. Within 4 days she became markedly hypertensive and developed status epilepticus. Brain MRI revealed patchy bilateral occipital lesions with T2 signal hyperintensity consistent with PRES. Her clinical exam, CSF, and electrophysiologic findings were consistent with GBS. She became relatively hypotensive and transthoracic echocardiogram showed severe apical akinesis. The patient clinically improved, and echocardiogram and MRI abnormalities resolved within 2 weeks. CONCLUSIONS: The autonomic effects of GBS may cause a variety of reversible clinical syndromes associated with sympathetic dysfunction including PRES and takotsubo cardiomyopathy; both of which are self-limited. Relative hypotension in GBS may be caused in part by neurogenic stunned myocardium.
BACKGROUND: To describe a patient with Guillane-Barré syndrome (GBS), posterior reversible encephalopathy syndrome (PRES) and takotsubo cardiomyopathy, and in doing so, to postulate a new mechanism for hypotension in the setting of dysautonomia in GBS. METHODS: Case report. RESULTS: We report an 82-year-old woman who presented with bilateral lower extremity weakness and back pain following an upper respiratory viral illness. Within 4 days she became markedly hypertensive and developed status epilepticus. Brain MRI revealed patchy bilateral occipital lesions with T2 signal hyperintensity consistent with PRES. Her clinical exam, CSF, and electrophysiologic findings were consistent with GBS. She became relatively hypotensive and transthoracic echocardiogram showed severe apical akinesis. The patient clinically improved, and echocardiogram and MRI abnormalities resolved within 2 weeks. CONCLUSIONS: The autonomic effects of GBS may cause a variety of reversible clinical syndromes associated with sympathetic dysfunction including PRES and takotsubo cardiomyopathy; both of which are self-limited. Relative hypotension in GBS may be caused in part by neurogenic stunned myocardium.
Authors: R B Schwartz; K M Jones; P Kalina; R L Bajakian; M T Mantello; B Garada; B L Holman Journal: AJR Am J Roentgenol Date: 1992-08 Impact factor: 3.959
Authors: Kevin A Bybee; Tomas Kara; Abhiram Prasad; Amir Lerman; Greg W Barsness; R Scott Wright; Charanjit S Rihal Journal: Ann Intern Med Date: 2004-12-07 Impact factor: 25.391
Authors: J Hinchey; C Chaves; B Appignani; J Breen; L Pao; A Wang; M S Pessin; C Lamy; J L Mas; L R Caplan Journal: N Engl J Med Date: 1996-02-22 Impact factor: 91.245
Authors: Stephan Grimaldi; Emilie Doche; Caroline Rey; Nadia Laksiri; Salah Boussen; Jacques Quilici; Emmanuelle Robinet; Fabien Devemy; Jean Pelletier Journal: Case Rep Neurol Date: 2017-07-11