Lyme disease triggers Guillian-Barre Syndrome

In a letter to the editor entitled “Lyme Disease as an Extremely Rare Cause of Guillain‑Barré Syndrome in India,” Sudheer Varma Y and colleagues describe the case of a 50‑year‑old woman who suddenly developed difficulty swallowing, slurred speech, and weakness and numbness in both upper and lower limbs.

Guillain-Barré Syndrome (GBS) is an autoimmune disorder in which your immune system mistakenly attacks the peripheral nerves surrounding the brain and spinal cord. GBS symptoms typically include weakness and/or tingling sensations in the legs, which can spread to the arms and upper body.

This patient also reported having three episodes of loose stools, two episodes of vomiting, and one episode of fever with chills and rigors.

A neurological exam found bulbar palsy of the ninth and tenth cranial nerves, reduced tone in all four limbs, absent deep tendon reflexes in the lower limbs, and absent bilateral plantar reflexes.

“Nerve conduction study suggested a demyelinating sensory‑motor polyneuropathy affecting both the upper and lower limbs, leading to a diagnosis of Guillain‑Barré syndrome (GBS),” the authors state.

The patient then developed lower motor neuron type of bilateral facial nerve palsy, which prompted testing for Lyme disease. Test results were positive and the woman was diagnosed with Guillain‑Barré Syndrome secondary to Lyme disease.

The patient was treated with intravenous immunoglobulin (IVIg), gabapentin, and a 14‑day course of IV ceftriaxone.