Guillain-Barré syndrome (GBS) is described classically as presenting with ascending paralysis. This can be misleading as there are several different phenotypes. This case report describes a case of descending paralysis mimicking myasthenia gravis in a middle-aged man. The pharyngeal-cervical-brachial (PCB) variant of GBS is characterized by bifacial weakness, dysphagia, and bilateral upper extremity paralysis and is typically a pure motor syndrome. This syndrome can mimic other more common disorders, such as stroke, leading to a delay in diagnosis. Increasing awareness of this atypical variant of GBS can improve earlier recognition by providers, which can lead to improved outcomes. His history, physical exam, diagnostic testing, hospital course, outcome, and treatment will be reviewed.
Wheeler RA. Descending Weakness: Dysphagia with Bilateral Upper Extremity Weakness. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2023; 5(1).
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