{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T14:25:29Z","timestamp":1761920729502,"version":"3.44.0"},"reference-count":25,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,4,7]]},"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:p>A 69-year-old woman presented with headaches and visual disturbance in the context of marked hypertension secondary to non-compliance with antihypertensive medications. She developed seizures and hyperreflexia, and MRI brain showed changes consistent with posterior reversible encephalopathy syndrome (PRES). She was treated with antihypertensives with the resolution of symptoms. Over the following week, she developed progressive distal sensory loss, weakness and areflexia. The cerebrospinal fluid examination demonstrated albuminocytologic dissociation, and electrophysiological findings were in keeping with a diagnosis of Guillain-Barr\u00e9 syndrome (GBS). She was treated with intravenous immunoglobulin with gradual recovery. The co-occurrence of PRES and GBS has only been described in a handful of cases. In the majority of these, the dysautonomia of GBS leads to profound hypertension and subsequently PRES. This is a rare case of PRES preceding and possibly even triggering the onset of GBS. In this report, we review the literature and discuss the potential pathogenic mechanisms for this unusual association.<\/jats:p>","DOI":"10.1136\/bcr-2019-234184","type":"journal-article","created":{"date-parts":[[2020,4,21]],"date-time":"2020-04-21T05:49:29Z","timestamp":1587448169000},"page":"e234184","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Guillain-Barr\u00e9 syndrome and posterior reversible leukoencephalopathy syndrome: a rare association"],"prefix":"10.1136","volume":"13","author":[{"given":"Stuti","family":"Joshi","sequence":"first","affiliation":[{"name":"Neurology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Prentice","sequence":"additional","affiliation":[{"name":"Internal Medicine, St John of God Hospital, Midland, Western Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jolandi","family":"van Heerden","sequence":"additional","affiliation":[{"name":"Perth Radiological Clinic, St John of God Hospital, Midland, Western Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Chemmanam","sequence":"additional","affiliation":[{"name":"Neurology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia"},{"name":"Neurology, St John of God Hospital, Midland, Western Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,4,20]]},"reference":[{"key":"2025082802082513000_13.4.e234184.1","doi-asserted-by":"publisher","DOI":"10.4065\/mcp.2009.0590"},{"key":"2025082802082513000_13.4.e234184.2","first-page":"II96","article-title":"Autonomic dysfunction in Guillain-Barr\u00e9 syndrome and multiple sclerosis","volume":"254 Suppl 2","author":"Flachenecker","year":"2007","journal-title":"J Neurol"},{"key":"2025082802082513000_13.4.e234184.3","doi-asserted-by":"crossref","unstructured":"Louie J , Igbokwe E , Hinchey J . Posterior reversible encephalopathy associated with the dysautonomia of Guillain-Barr\u00e9 syndrome. Neurol. Bull. 2009:7\u201310.doi:10.7191\/neurol_bull.2009.1001","DOI":"10.7191\/neurol_bull.2009.1001"},{"key":"2025082802082513000_13.4.e234184.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(97)90089-7"},{"key":"2025082802082513000_13.4.e234184.5","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2016-216757"},{"key":"2025082802082513000_13.4.e234184.6","doi-asserted-by":"crossref","first-page":"453","DOI":"10.2176\/nmc.cr.2018-0049","article-title":"Posterior reversible encephalopathy syndrome and Guillain-Barr\u00e9 syndrome after head injury: case report","volume":"58","author":"Yonekura","year":"2018","journal-title":"Neurol Med Chir"},{"key":"2025082802082513000_13.4.e234184.7","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1007\/s10286-018-0542-y","article-title":"Autonomic involvement in Guillain-Barr\u00e9 syndrome: an update","volume":"29","author":"Zaeem","year":"2019","journal-title":"Clin Auton Res"},{"key":"2025082802082513000_13.4.e234184.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2014.12.012"},{"key":"2025082802082513000_13.4.e234184.9","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(15)00111-8"},{"key":"2025082802082513000_13.4.e234184.10","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.15.3.413"},{"key":"2025082802082513000_13.4.e234184.11","doi-asserted-by":"publisher","DOI":"10.1385\/NCC:1:4:465"},{"key":"2025082802082513000_13.4.e234184.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2006.01.004"},{"key":"2025082802082513000_13.4.e234184.13","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1111\/j.1529-8027.2012.00416.x","article-title":"Posterior reversible encephalopathy syndrome as the initial manifestation of Guillain-Barr\u00e9 syndrome: case report and review of the literature","volume":"17","author":"Rigamonti","year":"2012","journal-title":"J Peripher Nerv Syst"},{"key":"2025082802082513000_13.4.e234184.14","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A4563"},{"key":"2025082802082513000_13.4.e234184.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2015.07.018"},{"key":"2025082802082513000_13.4.e234184.16","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1159\/000450603","article-title":"Guillain-Barr\u00e9 syndrome and cerebral hemorrhage: two cases and literature review","volume":"76","author":"Wu","year":"2016","journal-title":"Eur Neurol"},{"key":"2025082802082513000_13.4.e234184.17","doi-asserted-by":"crossref","first-page":"61","DOI":"10.20517\/2347-8659.2016.51","article-title":"Two cases of Guillain-Barr\u00e9 syndrome after cerebral hemorrhage or head trauma","volume":"4","author":"Jia","year":"2017","journal-title":"NN"},{"key":"2025082802082513000_13.4.e234184.18","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2012-302312"},{"key":"2025082802082513000_13.4.e234184.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2007.10.005"},{"key":"2025082802082513000_13.4.e234184.20","doi-asserted-by":"crossref","first-page":"1819","DOI":"10.4049\/jimmunol.157.5.1819","article-title":"The central nervous system as an immunocompetent organ: role of glial cells in antigen presentation","volume":"157","author":"Shrikant","year":"1996","journal-title":"J Immunol"},{"key":"2025082802082513000_13.4.e234184.21","doi-asserted-by":"crossref","first-page":"1452","DOI":"10.1016\/j.jocn.2009.11.037","article-title":"Severe Guillain-Barr\u00e9 syndrome following head trauma","volume":"17","author":"Tan","year":"2010","journal-title":"J Clin Neurosci"},{"key":"2025082802082513000_13.4.e234184.22","doi-asserted-by":"crossref","first-page":"595","DOI":"10.3171\/JNS\/2008\/108\/3\/0595","article-title":"Fulminant Guillain-Barr\u00e9 syndrome after closed head injury: a potentially reversible cause of an ominous examination. Case report","volume":"108","author":"Rivas","year":"2008","journal-title":"J Neurosurg"},{"key":"2025082802082513000_13.4.e234184.23","doi-asserted-by":"crossref","DOI":"10.1007\/s11916-015-0508-x","article-title":"Headache and pain in Guillain-Barr\u00e9 syndrome","volume":"19","author":"Farmakidis","year":"2015","journal-title":"Curr Pain Headache Rep"},{"key":"2025082802082513000_13.4.e234184.24","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0044534","article-title":"And the critically III posterior reversible encephalopathy syndrome Study Group (cypress). determinants of recovery from severe posterior reversible encephalopathy syndrome","volume":"7","author":"Legriel","year":"2012","journal-title":"PLoS One"},{"key":"2025082802082513000_13.4.e234184.25","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2009.189647"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-234184","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:08:36Z","timestamp":1756372116000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-234184"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4]]},"references-count":25,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2020,4,20]]},"published-print":{"date-parts":[[2020,4]]}},"alternative-id":["10.1136\/bcr-2019-234184"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-234184","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2020,4]]}}}