{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T12:20:00Z","timestamp":1788438000707,"version":"build-2803163510"},"reference-count":7,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,5,15]]},"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:p>Guillain-Barre syndrome (GBS) is an acute immune-mediated polyneuropathy classically presenting with ascending lower limb weakness; however, rare regional variants may pose diagnostic challenges. We report a case of an unusual upper limb-predominant variant of GBS following a self-limiting diarrhoeal illness, presenting with acute shoulder pain, progressive bilateral hand paraesthesia and upper limb weakness without lower limb, bulbar or cranial nerve involvement. Neurological examination demonstrated proximal and distal upper limb weakness with upper limb hyporeflexia. Cerebrospinal fluid analysis revealed albumin-cytologic dissociation; anti-GM1 antibodies were positive; cervical spine MRI excluded structural pathology and nerve conduction studies confirmed an axonal motor neuropathy consistent with the acute motor axonal neuropathy variant of GBS. The patient was treated with a 5-day course of intravenous immunoglobulin alongside physiotherapy, resulting in gradual neurological recovery and functional improvement. This case emphasises the importance of recognising atypical regional presentations of GBS to facilitate timely diagnosis and prompt initiation of immunomodulatory therapy.<\/jats:p>","DOI":"10.1136\/bcr-2026-271998","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T12:30:23Z","timestamp":1779971423000},"page":"e271998","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Upper limb-predominant variant of Guillain-Barre Syndrome (GBS) following diarrhoea"],"prefix":"10.1136","volume":"19","author":[{"given":"Sikandar","family":"Afzal","sequence":"first","affiliation":[{"name":"General Medicine & Endocrinology, Mayo University Hospital, Castlebar, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Giletta","sequence":"additional","affiliation":[{"name":"General Medicine & Endocrinology, Mayo University Hospital, Castlebar, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikitha","family":"Seni","sequence":"additional","affiliation":[{"name":"General Medicine & Endocrinology, Mayo University Hospital, Castlebar, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Sajjad","family":"Sadiq","sequence":"additional","affiliation":[{"name":"General Medicine & Endocrinology, Mayo University Hospital, Castlebar, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,5,27]]},"reference":[{"key":"2026090305101596000_19.5.e271998.1","doi-asserted-by":"crossref","first-page":"3646","DOI":"10.1111\/ene.16073","article-title":"European Academy of Neurology\/Peripheral Nerve Society Guideline on diagnosis and treatment of Guillain\u2013Barr\u00e9 syndrome","volume":"30","author":"van Doorn","year":"2023","journal-title":"Euro J of Neurology"},{"key":"2026090305101596000_19.5.e271998.2","unstructured":"Orphanet: acute motor axonal neuropathy. Orpha.net; 2019. Available: https:\/\/www.orpha.net\/en\/disease\/detail\/98918 [Accessed 09 Mar 2026]."},{"key":"2026090305101596000_19.5.e271998.3","doi-asserted-by":"crossref","DOI":"10.1212\/WNL.0000000000209725","article-title":"Antibodies in Autoimmune Neuropathies: What to Test, How to Test, Why to Test","volume":"103","author":"Pascual-Go\u00f1i","year":"2024","journal-title":"Neurology (ECronicon)"},{"key":"2026090305101596000_19.5.e271998.4","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2013-305397"},{"key":"2026090305101596000_19.5.e271998.5","article-title":"An Unusual Presentation of the Cervicobrachial Variant of Guillain-Barr\u00e9 Syndrome in a 32-Year-Old Previously Healthy Male","volume":"16","author":"Iltaf-Mairajuddin","year":"2024","journal-title":"Cureus"},{"key":"2026090305101596000_19.5.e271998.6","doi-asserted-by":"crossref","DOI":"10.1186\/s12883-022-02955-0","article-title":"Recurrent Guillain-Barr\u00e9 syndrome presenting as pharyngeal-cervical-brachial variant with three species of ganglioside antibodies:case report","volume":"22","author":"Luan","year":"2022","journal-title":"BMC Neurol"},{"key":"2026090305101596000_19.5.e271998.7","doi-asserted-by":"crossref","DOI":"10.1111\/ene.16365","article-title":"Guillain-Barr\u00e9 syndrome: a comprehensive review","volume":"31","author":"Bellanti","year":"2024","journal-title":"Eur J Neurol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2026-271998","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T12:10:36Z","timestamp":1788437436000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2026-271998"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":7,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5,27]]},"published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1136\/bcr-2026-271998"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2026-271998","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]}}}