Guillan-Barre Syndrome in a Patient with Uncontrolled Diabetes and Severe Peripheral Neuropathy

The complications of diabetes are frequently encountered in the Emergency Department. In contrast, Guillan-Barre Syndrome (GBS) is a relatively rare diagnosis requiring a high index of suspicion which can cause significant morbidity and mortality if not recognized and properly treated. GBS is an acquired condition which is usually preceded by a viral upper respiratory or gastrointestinal (GI) illness which can cause peripheral weakness and potentially diaphragmatic paralysis leading to life-threatening respiratory failure. Herein, we present a case of a 57-year-old male with a history of poorly-controlled diabetes who presented with both sensory and motor weakness of the distal upper and lower extremities; the patient was ultimately diagnosed with Guillan-Barre syndrome. This case illustrated an uncommon disease process that was initially mistaken for an extremely common disease both of which require very different management. This illustrative case is important to the emergency medicine physician because quick identification can stave off untoward complications and increased morbidity and mortality of GBS including respiratory distress and airway emergencies.