Guillain-Barré syndrome (GBS) is an acute, immune-mediated polyradiculoneuropathy with several atypical variants. The pharyngeal-cervical-brachial (PCB) variant is a rare subtype characterized by rapidly progressive weakness of the oropharyngeal, neck, and upper limb muscles, often with relative sparing of the lower limbs. We present a patient who developed progressive upper-limb weakness and neck involvement without significant lower-limb deficit, clinically consistent with the PCB variant of GBS. Daily neurological assessments showed no improvement until the 3rd day of admission, after which evolving findings of upper-limb hypotonia, absent reflexes, and preserved lower-limb power were observed. Serial monitoring of respiratory effort using single breath count remained satisfactory, ruling out early respiratory compromise. This case underscores the diagnostic importance of recognizing PCB-GBS, which may mimic brainstem or cervical spinal pathology and highlights the role of meticulous bedside monitoring and early immunotherapy in improving the outcomes.
Kanitkar et al. (Thu,) studied this question.