Bilateral Facial Palsy and Hyperreflexia as the Main Clinical Presentation in Guillain-Barré Syndrome

01 October 2021: Articles

Unusual clinical course, Challenging differential diagnosis

Ghada Albuainain ^A*

DOI: 10.12659/AJCR.932757

Am J Case Rep 2021; 22:e932757

Table 1. Nerve conduction study.

Motor nerve conduction
Nerve and site	Latency	Amplitude	Segment	Latency difference	Distance	Conduction velocity

Ankle	18.3 ms	1.8 mV	Extensor digitorum brevis-ankle	18.3 ms	90 mm	m/s
Fibula (head)	24.4 ms	1.8 mV	Ankle-fibula (head)	6.1 ms	280 mm	46 m/s
Popliteal fossa	24.9 ms	1.8 mV	Fibula (head)- popliteal fossa	0.5 ms	100 mm	200 m/s

Ankle	13.0 ms	0.9 mV	Abductor hallucis-ankle	13.0 ms	90 mm	m/s
Popliteal fossa	23.2 ms	0.7 mV	Ankle-popliteal fossa	10.2 ms	380 mm	37 m/s

Wrist	15.2 ms	2.2 mV	Abductor pollicis brevis-wrist	15.2 ms	80mm	m/s
Elbow	19.7 ms	2.1 mV	Wrist-elbow	4.5 ms	230 mm	51 m/s

Nasalis	3.3 ms	0.1 mV	Nasalis	0.6 ms	mm	m/s
Right facial
Nasalis	2.7 ms	1.0 mV	Nasalis	ms	mm	m/s

Nerve			M-latency		F-latency
Right peroneal			24.4		58.4
Right median			19.7		28.1
Motor responses from the right peroneal, tibial, and median nerves showed significant delay in distal latency in demyelinating range with absent F-wave motor responses. Sensory studies of the upper and lower limbs were normal.
Sensory nerve conduction
Nerve and site	Onset latency	Peak latency	Amplitude	Segment	Latency difference	Distance	Conduction velocity

Lower leg	2.4 ms	3.3 ms	14 microV	Ankle-lower leg	2.4 ms	140 mm	58 m/s
Motor responses from the right peroneal, tibial, and median nerves showed significant delay in distal latency in demyelinating range with absent F-wave motor responses. Sensory studies of the upper and lower limbs were normal.