Asymmetric limb weakness in Guillain-Barré syndrome: Three case reports

Table 1 Clinical features of patients with asymmetric Guillain-Barré syndrome

Characteristics	Report by Logullo et al[13]	Present report
	Case 1	Case 1	Case 2	Case 3
Age (yr)/sex	14/M	56/M	59/M	36/M
Antecedent illness	Gastroenteritis	Pneumonia	-	Gastroenteritis
At entry
GBS disability score	3	2	4	4
MRC sum-score
Left limb weakness	NA	26	16	15
Right limb weakness	NA	22	10	12
Sensory deficits	+	+	+	+
Tendon reflex	Normal	Areflexia	Areflexia	Hyporeflexia
Bulbar palsy	-	-	-	-
Ataxia	-	-	-	-
Cranial nerve involvement	-	-	-	-
Albuminocytological dissociation in CSF	+	+	+	+
Cerebral magnetic resonance imaging	None	-	-	-
IgG antibodies to	GM1	-	GM1	GM1
Nerve conduction studies	Axonal	Demyelination	NA	Axonal
Treatment	IVIg	IVIg	ST	PE
At nadir
Days between onset and nadir	16	5	9	4
GBS disability score	4	2	4	4
MRC sum-score
Left limb weakness	NA	26	8	8
Right limb weakness	NA	22	4	12
Sensory deficits	+	+	+	+
Tendon reflex	Areflexia	Areflexia	Areflexia	Areflexia
At six months after onset
GBS disability score	3	2	4	4
MRC sum-score
Left limb weakness	NA	29	12	15
Right limb weakness	NA	26	8	21
Sensory deficits	+	+	+	+
Tendon reflex	NA	Hyporeflexia	Areflexia	Hyporeflexia

GBS: Guillain-Barré syndrome; MRC: Medical Research Council; CSF: Cerebrospinal fluid; IVIg: Intravenous immunoglobulin; PE: Plasma exchange; ST: Supportive treatment; NA: Not available.