Hyperacute Gullain Barre Syndrome (GBS); The Catastrophic Variant- A Rare Case Report

Guillain-Barré syndrome (GBS) also known as acute demyelinating polyradiculoneuropathy (AIDP) is an immunologically mediated  rare neurological disorder.  The  basic pathogenic mechanism is regulated by molecular mimicry. Usually there is a history of preceding infection which occurs some weeks before the attack. The infections are gastroenteritis or upper respiratory. The clinical spectrum of ranges from  mild weakness to devastating paralysis including respiratory failure. Majority of the cases recover but a few continue to have residual neurodeficit. The usual clinical course of GBS from the starting of weakness to development of maximum neurologic progression usually progresses over 4 weeks. Hyperacute GBS is a term used when the progression of weakness occurs within hours to days to maximum neurologic impairment. In this case report we present a 28 year old female who developed rapidly progressive, areflexic quadriparesis with respiratory muscle involvement requiring mechanical ventilatory support within nine hours. Clinical , laboratory and nerve conduction studies suggested a diagnosis of GBS.