A 16-year-old man with a history of respiratory infection and self-limiting diarrhea one week prior to admission, three days later began with dysarthria, diplopia, dysphagia, limb paresthesia and ataxia.
Examination revealed dysarthria, dysparesis of the upper, lower and lateral rectuses, facial biparesis, velopalatine paresis, cephaloparesis, abolished bilateral osteotendinous reflexes (OTT).
Magnetic resonance imaging (MRI) of the brain was normal. Electromyography (EMG) showed generalized polyneuropathy, anti-LG sera positive to cerebrospinal fluid (CSF) and cerebrospinal fluid (CSF) positive antibodies.
She developed upper limb paresis and required orotracheal intubation for airway management.
The diagnosis of PFMS was established, as well as GBS variant of the pharyngocervical brachial artery.
Treatment with intravenous immunoglobulin (IVIG) was started, but she developed anaphylactic shock although she had normal immunoglobulin A levels.
Treatment with plasmapheresis was continued until completing 15 volemias.
At 6 months follow-up, minimal facial biparesis and reduced OTR were investigated.
