{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T06:14:37Z","timestamp":1785564877622,"version":"3.56.0"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,6,7]],"date-time":"2024-06-07T00:00:00Z","timestamp":1717718400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Bilateral facial palsy with paresthesia (FDP) is a rare variant of GBS, characterized by simultaneous bilateral facial palsy and paresthesia of the distal limbs. Mounting evidence indicates that the presence of anti-GT1a IgG has a pathogenic role as an effector molecule in the development of cranial nerve palsies in certain patients with GBS, whereas anti-GT1a antibody is rarely presented positive in FDP. Here, we report the case of a 33-year-old male diagnosed with FDP presented with acute onset of bilateral facial palsy and slight paresthesias at the feet as the only neurological manifestation. An antecedent infection with no identifiable reason for the fever or skin eruptions was noted in the patient. He also exhibited cerebrospinal fluid albuminocytologic dissociation and abnormal nerve conduction studies. Notably, the testing of specific serum anti-gangliosides showed positive anti-GT1a IgG\/IgM Ab. The patient responded well to intravenous immunoglobulin therapy. This case brings awareness to a rare variant of GBS, and provides the first indication that anti-GT1a antibodies play a causative role in the development of FDP. The case also suggests that prompt management with IVIG should be implemented if FDP is diagnosed.<\/jats:p>","DOI":"10.3389\/fimmu.2024.1410634","type":"journal-article","created":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T17:40:36Z","timestamp":1718127636000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Case report: Bilateral facial palsy with paresthesias and positive anti-GT1a antibodies"],"prefix":"10.3389","volume":"15","author":[{"given":"Xiaoxuan","family":"Xu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang","family":"Su","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Cong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongming","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,6,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1111\/jns.12115","article-title":"When is facial diplegia regarded as a variant of Guillain-Barr\u00e9 syndrome","volume":"20","author":"Kim","year":"2015","journal-title":"J Peripher Nerv Syst"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-009-5254-8","article-title":"A Guillain-Barr\u00e9 syndrome variant with prominent facial diplegia","volume":"256","author":"Susuki","year":"2009","journal-title":"J Neurol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00517-1","article-title":"Guillain-Barr\u00e9 syndrome","volume":"397","author":"Shahrizaila","year":"2021","journal-title":"Lancet"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.7860\/JCDR\/2016\/19951.8092","article-title":"Facial diplegia with paresthesia: an uncommon variant of Guillain-Barre syndrome","volume":"10","author":"Kumar","year":"2016","journal-title":"J Clin Diagn Res"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215100108199","article-title":"Recurrent bilateral peripheral facial palsy","volume":"103","author":"Stahl","year":"1989","journal-title":"J Laryngol Otol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-023-11897-7","article-title":"Acquired bilateral facial palsy: a systematic review on aetiologies and management","volume":"270","author":"Molinari","year":"2023","journal-title":"J Neurol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000002599","article-title":"Bilateral facial paralysis: A 13-year experience","volume":"138","author":"Gaudin","year":"2016","journal-title":"Plast Reconstr Surg"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2013.06.022","article-title":"Potential misdiagnoses of Bell's palsy in the emergency department","volume":"63","author":"Fahimi","year":"2014","journal-title":"Ann Emerg Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"C7","DOI":"10.1111\/j.1525-1497.2006.00466.x","article-title":"Bilateral facial paralysis: case presentation and discussion of differential diagnosis","volume":"21","author":"Jain","year":"2006","journal-title":"J Gen Intern Med"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1994.00540190051014","article-title":"Further regional variants of acute immune polyneuropathy. Bifacial weakness or sixth nerve paresis with paresthesias, lumbar polyradiculopathy, and ataxia with pharyngeal-cervical-brachial weakness","volume":"51","author":"Ropper","year":"1994","journal-title":"Arch Neurol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-019-0250-9","article-title":"Diagnosis and management of Guillain-Barr\u00e9 syndrome in ten steps","volume":"15","author":"Leonhard","year":"2019","journal-title":"Nat Rev Neurol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1111\/ene.16073","article-title":"European Academy of Neurology\/Peripheral Nerve Society Guideline on diagnosis and treatment of Guillain-Barr\u00e9 syndrome","volume":"30","author":"van Doorn","year":"2023","journal-title":"Eur J Neurol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awac067","article-title":"COVID-19 vaccination and Guillain-Barr\u00e9 syndrome: analyses using the National Immunoglobulin Database","volume":"146","author":"Keh","year":"2023","journal-title":"Brain"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-022-05982-4","article-title":"Bilateral facial palsy after COVID-19 vaccination","volume":"43","author":"Andreozzi","year":"2022","journal-title":"Neurol Sci"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1002\/lary.30333","article-title":"Facial nerve paralysis and COVID-19: A systematic review","volume":"133","author":"Namavarian","year":"2023","journal-title":"Laryngoscope"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1002\/mus.24887","article-title":"Isolated facial diplegia in Guillain-Barr\u00e9 syndrome: Bifacial weakness with paresthesias","volume":"52","author":"Wakerley","year":"2015","journal-title":"Muscle Nerve"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1080\/08998280.2022.2043679","article-title":"Facial diplegia with paresthesia associated with anti-GD1a antibodies","volume":"35","author":"Strawbridge","year":"2022","journal-title":"Proc (Bayl Univ Med Cent)"},{"key":"B18","doi-asserted-by":"publisher","first-page":"289","DOI":"10.21037\/atm-20-2285","article-title":"Detection of anti-ganglioside antibodies in Guillain-Barr\u00e9 syndrome","volume":"11","author":"Zhu","year":"2023","journal-title":"Ann Transl Med"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.72.6.767","article-title":"Anti-GT1a igG in Guillain-Barr\u00e9 syndrome","volume":"72","author":"Koga","year":"2002","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2013-305397","article-title":"Pharyngeal-cervical-brachial variant of Guillain-Barre syndrome","volume":"85","author":"Wakerley","year":"2014","journal-title":"J Neurol Neurosurg Psychiatry"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2024.1410634\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T17:40:48Z","timestamp":1718127648000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2024.1410634\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,7]]},"references-count":20,"alternative-id":["10.3389\/fimmu.2024.1410634"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2024.1410634","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,7]]},"article-number":"1410634"}}