A Case of Recurrent Facial Palsy Associated with Anti-GM2: is it anyway Guillain-barré syndrome?


A Case of Recurrent Facial Palsy Associated with Anti-GM2: is it anyway Guillain-barré syndrome?


Giovanni Bonaccorso

Region skåne


Objective: A rare case of possible hereditary predisposition to autoimmune neuropathy

Background: This case report is of a patient who presented two episodes of Facial paresis in her live without ascertained apparent causes. Bell’s palsy is commonly known as peripheral idiopathic facial nerve palsy, because in the most cases the triggers remain unknown (1).

Case Report: I want to present a case of a 34 year old woman who we will call A.B. and who came to us to evaluate the severity of the sequelae of a Bell´s palsy and any eventual need for cosmetic measure. But she had another Bell´s Palsy 9 years ago, so I started to investigate the most common and treatable causes of Facial paresis. I found a significate increase of anti-bodies against ganglioside GM2. When I explained to her that these anti-bodies is commonly related with several neurological diseases, she started to investigate her family history and she found that his father’s brother died of Guillain Barré syndrome about 40 years ago.


Keywords: Bell´s palsy, facial, palsy, paresis, Guillain Barré syndrome, ganglioside, Antibodies, GM2.


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How to cite this article:

Giovanni Bonaccorso. SA Case of Recurrent Facial Palsy Associated with Anti-GM2: is it anyway Guillainbarré syndrome?. International Journal of Case Reports, 2021 5:213. DOI: 10.28933/ijcr-2021-04-0505


References:

1. J. G. Heckmann, P. P. Urban, S. Pitz, et al. The Diagnosis and Treatment od Idiopathic Facial Paresis (Bell´s Palsy). Dtsch Arztebl Int. 2019 Oct 11;116(41):692-702.
2. A. D. Van Amstel, P. P. Devriese. Clinical experiences with recurrences of Bell´s palsy. Arch Otorhinolaryngol. 1988; 245(5):302-6.
3. N. Auger, C. Quach, J. Healy-Profitos, et al. Early predictors of Guillain-Barre syndrome in the life course of women. International Journal of Epidemiology, 2018, 280-288.
4. P. Mancini, V. Bottardo, F. Capitani, et al. Recurrent Bell´s palsy: outcomes and correlation withclinical comorbidities. ACTA OTORHINOLARYNGOLOGICA ITALICA 2019;39:316-321.
5. S. H. Dong, A. R. Jung, J. Jung, et al. Recurrent Bell´s palsy. Clinical Otolaryngology. 2019;44:305–312.
6. A. Greco, A. Gallo, M. Fuscoli, et al. Bell´s palsy and autoimmunity. Autoimmunity Reviews 12 (2012) 323–328.
7. N. Smith, P. Grattan-Smith, P. I. Andrews, et al. Acquired facial palsy with hypertension secondary to Guillain–Barre syndrome. J Paediatr Child Health. 2010 Mar;46(3):125-7.
8. S. Nishiguchi, J. Branch, T. Tsuchiya, et al. Guillain-Barré syndrome: A variant consisting of Facial Diplegia and Paresthesia with Left Facial Hemiplegia Associated with Antibodies to Galactocerebroside and Phosphatidic Acid. Am J Case Rep, 2017; 18: 1048-1052
9. T. Mathew, P. Hareesh, D.D. Souza, et al. Bell’s palsy and guillain–barré syndrome may be 2 ends of the same spectrum. Muscle & Nerve.2019 Jun;59(6):E48-E49.
10. M. Yilmaz, M. Tarakcıoglu, N. Bayazıt, et al. Serum cytokine levels in Bell´s palsy. Journal of the Neuological Sciences 197 (2002) 69-72.
11. C. Gorodezky, J.M. Carranza, A. Bustamante, et al. The HLA System and T-Cell Subsets in Bell´s Palsy. Acta Otolaryngol. (Stockh). 1991; 11: 1070-1074.
12. A. Aviel, E. Ostfeld, R. Burstein. Peripheral blood T and B lymphocyte subpopulations in Bell’s palsy. Ann Otol Rhinol Laryngol. Mar-Apr 1983;92(2 Pt 1):187-91.
13. C. Bardage, I. Persson, Å. Örtqvist. Neurological and autoimmune disorders after vaccination against pandemic influenza A (H1N1) with a monovalent adjuvanted vaccine: population based cohort study in Stockholm, Sweden. British Medical Journal. 2011; 343: d5956.
14. K. Kaida, T. Ariga, R. K. Yu. Antiganglioside antibodies and their pathophysiological effects on Guillain–Barré syndrome and related disorders – A review. Glycobiology. 2009 Jul; 19(7): 676–692.
15. K. Kaida, S. Kusunoki. Antibodies to gangliosides and ganglioside complexes in Guillain–Barré syndrome and Fisher syndrome: Mini-review. Journal of Neuroimmunology 223 (2010) 5–12.
16. S. Nishiguchi, J. Branch, T. Tsuchiya, et al. Guillain-Barré Syndrome: A Variant Consisting of Facial Diplegia and Paresthesia with Left Facial Hemiplegia Associated with Antibodies to Galactocerebroside and Phosphatidic Acid. American Journal of Case Reports, 2017; 18: 1048-1052.
17. J. K. Kim, Y. H. Kim, B.-A. Yoon, et al. Clinical Heterogeneity of Anti-GM2-Ganglioside-Antibody Syndrome. Journal of Clinical Neurology, 2018;14(3):401-406.
18. C. Teles Silva, S. Silva, M. João Silva, et al. Guillain-Barré Syndrome in a Teenage Girl: A Severe Case With Anti-GM2 Antibodies Associated With Acute CMV Infection and Literature Review. Clinical Pediatrics (Phila). 2020 Mar;59(3):300-304.
19. C.W. Ang, B.C. Jacobs, A.H. Brandenburg, et al. Cross-reactive antibodies against GM2 and CMV-infected fibroblasts in Guillain–Barré syndrome. NEUROLOGY 2000; 54:1453–1458.
20. D. Qin, Z. Ouyang, W. Luo. Familial recurrent Bell´s palsy. Neurology India. Nov-Dec 2009;57(6):783-4.
21. J.C. Kattah, V. Rajajee, Y. Wakabayashi. Familial Bell´s Palsy: A Case Report and Literature Review.
22. K. Saigoh, T. Izumikawa, T. Koike, et al. Chondroitin beta-1,4-N-acetylgalactosaminyltransferase-1 missense mutations are associated with neuropathies. Journal of Human Genetics (2011) 56, 143-146.