Which symptoms suggest cranial nerve involvement in Guillain-Barre syndrome (GBS)?

Updated: May 04, 2018
  • Author: Michael T Andary, MD, MS; Chief Editor: Milton J Klein, DO, MBA  more...
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Answer

Cranial nerve involvement is observed in 45-75% of patients with GBS. Cranial nerves III-VII and IX-XII may be affected. Common complaints include the following:

  • Facial droop (may mimic Bell palsy)

  • Diplopias

  • Dysarthria

  • Dysphagia

  • Ophthalmoplegia

  • Pupillary disturbances

Facial and oropharyngeal weakness usually appears after the trunk and limbs are affected. The Miller-Fisher variant of GBS is unique in that this subtype begins with cranial nerve deficits. [95]


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