Atypical Guillain-Barré Syndrome Presenting After COVID-19 Infection

Abstract

Guillain-Barré syndrome (GBS) is an acute autoimmune disease affecting the peripheral nervous system presenting as a symmetric, ascending polyneuropathy. The syndrome arises after a stimulus, such as infection or vaccination, and provokes an autoimmune response in the body. Common symptoms include rapidly progressive weakness in the extremities and generalized hyporeflexia or areflexia. However, GBS may have various presentations, which can make for a challenging diagnosis. We present a case of a 46-year-old female with asymmetric ascending weakness, paresthesias, and acute onset urinary retention occurring after Coronavirus Disease 2019 (COVID-19) infection. Of note, this patient did not present with albuminocytologic dissociation in cerebrospinal fluid (CSF) studies. The complex presentation of her symptoms prompted a diagnosis of atypical GBS. Her diagnosis was achieved through a series of diagnostic tests ruling out other etiologies, such as meningitis and spinal cord compression syndromes.