An Acute Pharyngeal-Cervical-Brachial (PCB) variant of Guillain-Barre Syndrome

• Author Details:   
• Vivek Kumar
• Sumanto Chaterjee
• Dhruv Bansal
• Kiran Kaushal

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Acute Guillain Barre Syndrome [GBS] is characterized by an acute onset of limb weakness and areflexia. There are a few rare variants that have been described and one of them is the pharyngeal–cervical-brachial[PCB] variant [involving oropharynx, neck and proximal upper limb muscles]. Many neurologists and physicians are unaware of this variant which is often misdiagnosed as myasthenia gravis, brainstem stroke or botulism. A 37 year old female patient presented with the classical characteristics including bulbar weakness, cervicobrachial weakness and are flexia in the upper limbs, with relatively preserved lower limbs. Her systemic review was unremarkable. Her physical examination was compatible with GBS. Nerve conduction studies revealed Motor Axonal Radiculoneuropathy. She received 5 day course of IVIG and showed significant improvement over next 1 week. The patient recovered well and was discharged after 12 days.

Keywords: Guillain Barre Syndrome, Pharyngeal-Cervical-Brachial Variant