{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:00:13Z","timestamp":1787025613849,"version":"build-2736575974"},"reference-count":12,"publisher":"IMR Press","issue":"1","license":[{"start":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T00:00:00Z","timestamp":1739318400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Neurol."],"abstract":"<jats:p>Introduction: We present a rare case of acute immune-mediated polyradiculoneuritis, a Guillain-Barr\u00e9 Syndrome (GBS) variant, manifesting as ophthalmoparesis-ataxia, facial diplegia, and acute bulbar palsy, accompanied by a unique autoimmune profile. Clinical Case: A 75-year-old female developed rapidly progressive symptoms, including bilateral non-reactive mydriasis, ptosis, complete ophthalmoplegia, bilateral facial weakness, tongue immobility, palatal paralysis, limb dysmetria, ataxia, and brisk generalized tendon reflexes, all while maintaining a preserved mental state. Symptoms emerged 10 days after a probable gastrointestinal infection. Severe bulbar dysfunction necessitated orotracheal intubation and a tracheotomy. Extensive cranial nerve involvement initially suggested a brainstem lesion, with oculomotor and acute bulbar palsy as prominent signs. However, brainstem and spinal magnetic resonance imaging along with cerebrospinal fluid analysis yielded negative results. Electromyography reveled a sensorimotor demyelinating polyradiculoneuropathy, and serum testing identified IgG antibodies targeting multiple gangliosides, including the disialosyl group and terminal NeuNAc(\u03b12-3)Gal. Treatment with intravenous immunoglobulin (IVIG) led to gradual clinical improvement. Conclusions: This case highlights a rare and severe GBS phenotype characterized by reactivity to multiple gangliosides. It highlights the role of shared ganglioside epitopes in antibody-mediated neurological damage and expands the clinical spectrum of GBS variants.<\/jats:p>","DOI":"10.31083\/rn37744","type":"journal-article","created":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T03:50:27Z","timestamp":1741319427000},"source":"Crossref","is-referenced-by-count":2,"title":["A Rare Guillain-Barr\u00e9 Syndrome Variant with Multi-Ganglioside Reactivity: A Case of Severe Cranial Nerve Involvement"],"prefix":"10.31083","volume":"80","author":[{"given":"Laura","family":"G\u00f3mez-Dab\u00f3","sequence":"first","affiliation":[{"name":"Department of Neurology, University Hospital Vall d\u2019Hebron, Universitat Aut\u00f2noma de Barcelona, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4655-6157","authenticated-orcid":true,"given":"Arnau","family":"Llaurado","sequence":"first","affiliation":[{"name":"Neuromuscular Diseases Unit, Neurology Department, University Hospital Vall d\u2019Hebron, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"S\u00e1nchez-Tejerina","sequence":"first","affiliation":[{"name":"Neuromuscular Diseases Unit, Neurology Department, University Hospital Vall d\u2019Hebron, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Gonz\u00e1lez","sequence":"first","affiliation":[{"name":"Department of Neurology, University Hospital Vall d\u2019Hebron, Universitat Aut\u00f2noma de Barcelona, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Montalvo-Olmedo","sequence":"first","affiliation":[{"name":"Department of Neurology, University Hospital Vall d\u2019Hebron, Universitat Aut\u00f2noma de Barcelona, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"L\u00e1zaro-Hern\u00e1ndez","sequence":"first","affiliation":[{"name":"Department of Neurology, University Hospital Vall d\u2019Hebron, Universitat Aut\u00f2noma de Barcelona, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Rodrigo-Gisbert","sequence":"first","affiliation":[{"name":"Department of Neurology, University Hospital Vall d\u2019Hebron, Universitat Aut\u00f2noma de Barcelona, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"L\u00f3pez-Maza","sequence":"first","affiliation":[{"name":"Department of Neurology, University Hospital Vall d\u2019Hebron, Universitat Aut\u00f2noma de Barcelona, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maider","family":"Iza-Achutegui","sequence":"first","affiliation":[{"name":"Department of Neurology, University Hospital Vall d\u2019Hebron, Universitat Aut\u00f2noma de Barcelona, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00eddia","family":"Giram\u00e9-Rizzo","sequence":"first","affiliation":[{"name":"Department of Neurology, University Hospital Vall d\u2019Hebron, Universitat Aut\u00f2noma de Barcelona, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuria","family":"Raguer","sequence":"first","affiliation":[{"name":"Department of Clinical Neurophysiology, Vall d\u2019Hebron University Hospital, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ra\u00fal","family":"Juntas","sequence":"first","affiliation":[{"name":"Neuromuscular Diseases Unit, Neurology Department, University Hospital Vall d\u2019Hebron, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16242","published-online":{"date-parts":[[2025,2,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Shahrizaila N, Lehmann HC, Kuwabara S. 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