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Abstract

Myocarditis in Guillain-Barre syndrome is exceptionally rare, with only a few reported cases to date, highlighting the unusual nature of this occurrence. Guillain-Barre syndrome typically presents with ascending muscle weakness and a symmetric loss of deep tendon reflexes. Involvement of the cranial nerves and autonomic dysfunction can also be seen.
We report a peculiar case of Guillain-Barre syndrome with an atypical presentation, complicated by myocarditis, in a 17-year-old female. She exhibited asymmetrical descending paralysis, difficulty swallowing, abducens nerve palsy, shortness of breath, and significant hemodynamic instability. Guillain-Barre syndrome was diagnosed based on clinical findings, supported by cerebrospinal fluid analysis. Myocarditis was diagnosed based on clinical symptoms, elevated cardiac biomarkers, and echocardiographic findings.
The patient underwent five sessions of plasmapheresis, resulting in an improvement in her Guillain-Barre syndrome symptoms. Myocarditis was managed symptomatically. The patient remained in the Intensive Care Unit (ICU) for two months before being discharged home.