PT  - JOURNAL ARTICLE
AU  - Carley Drye
AU  - Subhasish Bose
AU  - Samata Pathireddy
AU  - Narothama Reddy Aeddula
TI  - Guillain-Barre syndrome with concurrent posterior reversible encephalopathy syndrome and hyponatraemia: mere coincidence or rare coexistence
AID  - 10.1136/bcr-2019-229749
DP  - 2019 Jul 01
TA  - BMJ Case Reports
PG  - e229749
VI  - 12
IP  - 7
4099  - http://casereports.bmj.com/content/12/7/e229749.short
4100  - http://casereports.bmj.com/content/12/7/e229749.full
SO  - BMJ Case Reports2019 Jul 01; 12
AB  - A 61-year-old Caucasian woman with a history of hypertension presented with a week’s history of confusion falls and back pain was found to have hyponatraemia from secretion of antidiuretic hormone and treated appropriately. Given her persistent symptoms, despite a normal CT head on presentation, an MRI head was obtained, showing vasogenic oedema in line with posterior reversible encephalopathy syndrome (PRES). Despite aggressive antihypertensives and supportive measures, unfortunately, her condition deteriorated, with increased confusion, new left-sided flaccid paresis, paraesthesias and worsening of the back pain. Following further testing including a cerebrospinal fluid analysis, finally diagnosed with an atypical presentation of Guillain-Barre syndrome (GBS), and prompt management with intravenous immunoglobulins was initiated. She recovered clinically and returned to near-normal function on follow-up. We use this case to suggest the importance of dysautonomia in GBS and various clinical manifestations it can present with, including PRES and hyponatraemia.