A Case of Pharyngeal-Cervical-Brachial Variant of Guillain-Barré Syndrome With Bilateral Glossopharyngeal Paralysis

Guillain-Barre Syndrome (GBS) is a rapidly evolving autoimmune inflammatory disease of the peripheral nerves. It classically presents with progressive symmetrical ascending muscle weakness and hyporeflexia. The pharyngeal-cervical-brachial (PCB) variant is a rare variant of GBS that is characterized by axonal rather than demyelinating neuropathy and presents with rapidly progressive oropharyngeal (facial palsy, dysarthria) and cervicobrachial weakness, associated upper limb weakness, and hyporeflexia. Because it is rare, the PCB variant of GBS is unfamiliar to many neurologists and it is often misdiagnosed as stroke, myasthenia gravis, or botulism. The prevalence of this variant is estimated to be about 3% of all GBS patients. We describe the only known case presentation of the PCB variant of GBS that presents with bilateral glossopharyngeal paralysis. A 39-year-old African American female presented with progressive oropharyngeal and cervicobrachial weakness along with bilateral glossopharyngeal paralysis. The patient was diagnosed based on clinical suspicion, presentation, and serum ganglioside antibodies.