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Acute Facial Dyplegia and Rhabdomyolisis: Case Report and Review of Literature

Received: 14 August 2019    Accepted: 26 August 2019    Published: 12 September 2019
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Abstract

In 1916, Guillain, Barré and Strohl reported on two cases of acute flaccid paralysis with high cerebrospinal fluid protein levels and normal cell counts-novel findings that identified the disease we now know as Guillain–Barré syndrome (GBS). 100 years on, we have made great progress with the clinical and pathological characterization of GBS. GBS is an acute/subacute-onset polyradiculoneuropathy typically presenting with sensory symptoms and weakness over several days, often leading to quadriparesis. Approximately 70% of patients report a recent preceding upper or lower respiratory tract infection or gastrointestinal illness. The interplay between the microbial and host factors that dictate whether and how the immune response shifts towards autoreactivity is still unclear, and nothing is known about the genetic and environmental factors that affect an individual's susceptibility to the disease. Facial Diplegia with Paresthesias is a rare localized variant of GBS in which patient presents with simultaneous facial diplegia, distal limb paresthesias and minimal or no motor weakness. Treatment with intravenous immunoglobulin or plasma exchange is the optimal management approach, alongside supportive care. A common misconception is that the Guillain–Barré syndrome has a good prognosis-but up to 20% of patients remain severely disabled and approximately 5% die, despite immunotherapy. We report the case of a woman with acute facial dyplegia and rhabdomyolisis improved after immunoglobulin treatment.

Published in Clinical Medicine Research (Volume 8, Issue 4)

This article belongs to the Special Issue Neurology Emergency

DOI 10.11648/j.cmr.20190804.13
Page(s) 85-92
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Facial Dyplegia, Hyperckemia, Guillain Barrè Syndrome

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Cite This Article
  • APA Style

    Maria Sofia Cotelli, Filippo Manelli, Marinella Turla. (2019). Acute Facial Dyplegia and Rhabdomyolisis: Case Report and Review of Literature. Clinical Medicine Research, 8(4), 85-92. https://doi.org/10.11648/j.cmr.20190804.13

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    ACS Style

    Maria Sofia Cotelli; Filippo Manelli; Marinella Turla. Acute Facial Dyplegia and Rhabdomyolisis: Case Report and Review of Literature. Clin. Med. Res. 2019, 8(4), 85-92. doi: 10.11648/j.cmr.20190804.13

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    AMA Style

    Maria Sofia Cotelli, Filippo Manelli, Marinella Turla. Acute Facial Dyplegia and Rhabdomyolisis: Case Report and Review of Literature. Clin Med Res. 2019;8(4):85-92. doi: 10.11648/j.cmr.20190804.13

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  • @article{10.11648/j.cmr.20190804.13,
      author = {Maria Sofia Cotelli and Filippo Manelli and Marinella Turla},
      title = {Acute Facial Dyplegia and Rhabdomyolisis: Case Report and Review of Literature},
      journal = {Clinical Medicine Research},
      volume = {8},
      number = {4},
      pages = {85-92},
      doi = {10.11648/j.cmr.20190804.13},
      url = {https://doi.org/10.11648/j.cmr.20190804.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20190804.13},
      abstract = {In 1916, Guillain, Barré and Strohl reported on two cases of acute flaccid paralysis with high cerebrospinal fluid protein levels and normal cell counts-novel findings that identified the disease we now know as Guillain–Barré syndrome (GBS). 100 years on, we have made great progress with the clinical and pathological characterization of GBS. GBS is an acute/subacute-onset polyradiculoneuropathy typically presenting with sensory symptoms and weakness over several days, often leading to quadriparesis. Approximately 70% of patients report a recent preceding upper or lower respiratory tract infection or gastrointestinal illness. The interplay between the microbial and host factors that dictate whether and how the immune response shifts towards autoreactivity is still unclear, and nothing is known about the genetic and environmental factors that affect an individual's susceptibility to the disease. Facial Diplegia with Paresthesias is a rare localized variant of GBS in which patient presents with simultaneous facial diplegia, distal limb paresthesias and minimal or no motor weakness. Treatment with intravenous immunoglobulin or plasma exchange is the optimal management approach, alongside supportive care. A common misconception is that the Guillain–Barré syndrome has a good prognosis-but up to 20% of patients remain severely disabled and approximately 5% die, despite immunotherapy. We report the case of a woman with acute facial dyplegia and rhabdomyolisis improved after immunoglobulin treatment.},
     year = {2019}
    }
    

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    AU  - Maria Sofia Cotelli
    AU  - Filippo Manelli
    AU  - Marinella Turla
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    AB  - In 1916, Guillain, Barré and Strohl reported on two cases of acute flaccid paralysis with high cerebrospinal fluid protein levels and normal cell counts-novel findings that identified the disease we now know as Guillain–Barré syndrome (GBS). 100 years on, we have made great progress with the clinical and pathological characterization of GBS. GBS is an acute/subacute-onset polyradiculoneuropathy typically presenting with sensory symptoms and weakness over several days, often leading to quadriparesis. Approximately 70% of patients report a recent preceding upper or lower respiratory tract infection or gastrointestinal illness. The interplay between the microbial and host factors that dictate whether and how the immune response shifts towards autoreactivity is still unclear, and nothing is known about the genetic and environmental factors that affect an individual's susceptibility to the disease. Facial Diplegia with Paresthesias is a rare localized variant of GBS in which patient presents with simultaneous facial diplegia, distal limb paresthesias and minimal or no motor weakness. Treatment with intravenous immunoglobulin or plasma exchange is the optimal management approach, alongside supportive care. A common misconception is that the Guillain–Barré syndrome has a good prognosis-but up to 20% of patients remain severely disabled and approximately 5% die, despite immunotherapy. We report the case of a woman with acute facial dyplegia and rhabdomyolisis improved after immunoglobulin treatment.
    VL  - 8
    IS  - 4
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Author Information
  • Neurology Unit, Azienda Socio Sanitaria Territoriale Valcamonica-Esine, Brescia, Italy

  • Emergency Unit, Azienda Socio Sanitaria Territoriale Valcamonica-Esine, Brescia, Italy

  • Neurology Unit, Azienda Socio Sanitaria Territoriale Valcamonica-Esine, Brescia, Italy

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