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Severe dysautonomic onset of Guillain-Barré syndrome with good recovery. A clinical and autonomic follow-up study

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A 39 year old man with acute panautonomic and mild somatic neuropathy had severe postural hypotension 1 week after onset. Porphyric neuropathy was excluded. The final diagnosis was Guillain-Barré syndrome (GBS). After 2 months he began to recover progressively and after 9 months he presented asymptomatic postural hypotension. We consider the hypothesis of a spectrum of clinico-pathological entities at one end of which lies GBS with autonomic signs and at the other acute pure dysautonomia. The site of the autonomic lesion, might have been in post-ganglionic sympathetic fibers and vagus nerve.


Abbiamo osservato un uomo di 39 anni colpito da una severa neuropatia autonomica acuta associata a una lieve neuropatia somatica. La diagnosi di porfiria fu esclusa e la diagnosi finale è stata di sindrome di Guillain-Barré (GBS). Dopo 2 mesi il paziente cominciò a migliorare e 9 mesi dopo presentava solo una lieve ipotensione ortostatica asintomatica. Viene discussa l'ipotesi di uno spettro di entità clinico-patologiche da un lato del quale risiede la GBS e dall'altro le forme di neuropatia autonomica acuta. Nel nostro caso la sede della lesione autonomica potrebbe essere nelle fibre simpatiche post-gangliari e nel nervo vago.

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Cortelli, P., Contin, M., Lugaresi, A. et al. Severe dysautonomic onset of Guillain-Barré syndrome with good recovery. A clinical and autonomic follow-up study. Ital J Neuro Sci 11, 157–162 (1990).

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