S33. Two case reports of ganglioside-associated Guillain-Barré syndrome with onset of respiratory muscle paralysis

Introduction Guillain–Barre syndrome (GBS) is an immune-mediated disorder of the peripheral nervous system presenting with inflammatory infiltration, typically sporadic, appearing following an infection. Since ganglioside preparations were introduced in clinical practice, in 1975, scholars from around the world have been reporting cases of exogenous ganglioside-associated GBS, with acute, severe and rapidly worsening peripheral nerve involvement, initially presenting with flaccid paralysis of the limbs. Methods We report two cases of ganglioside-associated GBS, for which the initial symptom was respiratory muscle paralysis. Results Exogenous gangliosides can cause severe GBS, with most electrophysiological studies showing damage to axons of motor nerves,and it is extremely rare that ganglioside-associated GBS present with initial respiratory muscle paralysis. Conclusion Immediate electrophysiological examination and detection of anti-ganglioside antibodies should be considered for patients presenting sudden dyspnea, after intravenous infusion of exogenous gangliosides. Once GBS is established, patients should be given IVIg or PE, which will aid in improving the patient’s neurological functions.