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Peer-reviewedCC BYOxford medical case reports

One trigger, two systems: post-infectious severe Guillain-Barre syndrome with concurrent central nervous system demyelination": a case report.

  • Mohammad Numan1,2
  • Mohammad Alhatou3
  • Zaeem Hussain2
  • Maidah Hussain4
  • Abraham Alhatou5
  • Wasfy Hamad1
5 affiliations
  1. 1Department of Pulmonary and MICU, Al-Khor Hospital, Hamad Medical corporation, Zone 74, Um Enaig street, Al Thakhera, P.O. Box 3050 Doha, Qatar.
  2. 2Internal Medicine, Collage of Medicine, Qatar University, Zone 68, Al- Jameaa street, Jelaiah, P.O. Box 2713, Doha, Qatar.
  3. 3Department of Neurology, Al-Khor Hospital, Hamad Medical corporation, Zone 74, Um Enaig street, Al Thakhera, P.O. Box 3050 Doha, Qatar.
  4. 4Karachi Institute of Medical Sciences, CMH Malir, Karachi, Sindh 75080, Pakistan.
  5. 5Lincoln Memorial University - DeBusk College of Osteopathic Medicine (LMU-DCOM), Knoxville, 9737 Cogdill Road, TN 37932, United States.
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Abstract

Combined central and peripheral demyelination is a rare but serious neurological condition that is associated with poor outcomes. We report a 31-year-old male presenting with rapidly progressive Acute inflammatory demyelinating polyradiculoneuropathy (AIDP) variant of Guillain-Barré syndrome following an upper respiratory tract infection. The course was complicated by respiratory failure requiring intubation and significant autonomic dysfunction. Despite treatment with intravenous immunoglobulin, there was minimal clinical improvement. Further imaging of the central nervous system revealed multiple acute demyelinating lesions involving the brain and spinal cord. The patient subsequently received plasmapheresis and high-dose intravenous steroids without significant neurological recovery. A severe hospital-acquired infection delayed rituximab initiation until four months after symptom onset; however, neurological recovery remained minimal. This case highlights the rare coexistence of post-infectious central and peripheral demyelination. Early recognition of central involvement in patients with poor response to standard GBS therapy may help guide escalation of immunotherapy and potentially improve outcomes.

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Cite

BibTeXRIS
BibTeX
@article{numan2026trigger,
  title = {{One trigger, two systems: post-infectious severe Guillain-Barre syndrome with concurrent central nervous system demyelination": a case report.}},
  author = {Mohammad Numan and Mohammad Alhatou and Zaeem Hussain and Maidah Hussain and Abraham Alhatou and Wasfy Hamad},
  journal = {Oxford medical case reports},
  year = {2026},
  month = oct,
  doi = {10.1093/omcr/omag202},
  url = {https://europepmc.org/article/MED/42928892},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - One trigger, two systems: post-infectious severe Guillain-Barre syndrome with concurrent central nervous system demyelination": a case report.
AU  - Mohammad Numan
AU  - Mohammad Alhatou
AU  - Zaeem Hussain
AU  - Maidah Hussain
AU  - Abraham Alhatou
AU  - Wasfy Hamad
PY  - 2026
DA  - 2026/10/25
JO  - Oxford medical case reports
DO  - 10.1093/omcr/omag202
UR  - https://europepmc.org/article/MED/42928892
AB  - Combined central and peripheral demyelination is a rare but serious neurological condition that is associated with poor outcomes. We report a 31-year-old male presenting with rapidly progressive Acute inflammatory demyelinating polyradiculoneuropathy (AIDP) variant of Guillain-Barré syndrome following an upper respiratory tract infection. The course was complicated by respiratory failure requiring intubation and significant autonomic dysfunction. Despite treatment with intravenous immunoglobulin, there was minimal clinical improvement. Further imaging of the central nervous system revealed multiple acute demyelinating lesions involving the brain and spinal cord. The patient subsequently received plasmapheresis and high-dose intravenous steroids without significant neurological recovery. A severe hospital-acquired infection delayed rituximab initiation until four months after symptom onset; however, neurological recovery remained minimal. This case highlights the rare coexistence of post-infectious central and peripheral demyelination. Early recognition of central involvement in patients with poor response to standard GBS therapy may help guide escalation of immunotherapy and potentially improve outcomes.
SN  - 2053-8855
ER  -